Manifestação neurológica na síndrome de Baggio-Yoshinari (síndrome brasileira semelhante à doença de Lyme)

Abstract

Introduction: Lyme disease (LD) is a tick-borne disease, caused by Borrelia burgdorferi sensu lato spirochetes, transmitted by Ixodes ricinus complex ticks, which leads to multiple systemic clinical manifestations. In Brazil, a different syndrome is described that mimics LD symptoms, but that also manifests high frequencies of recurrent episodes and immune-allergic manifestations. It is transmitted by the Amblyomma cajennense tick and the etiological agent is an uncultivable spirochete with atypical morphology. Due to its particularities, this emerging zoonosis has been called Brazilian LD-like syndrome or Baggio-Yoshinari Syndrome (BYS). Objective: To describe the neurological spectrum of BYS. Patients: Thirty patients with neurological symptoms of BYS were analyzed. Results: Mean age of patients was 34.2 ± 13.3 years old (6 to 63 years); 20 were females and 10 males. A high number of recurrent episodes (73.6%) and severe psychiatric or psycho-social disturbances (20%) were distinguishing features. Erythema migrans similar to those seen in the Northern hemisphere was identified in 43.3% of patients at disease onset. The recurrence of skin lesions diminished as the disease progressed. Articular symptoms (arthritis) happened in nearly half of patients at BYS onset and during relapsing episodes. Conclusions: The BYS is considered a new tick borne disease in Brazil that differs from classical LD observed in the Northern hemisphere. BYS replicates most of the neurological symptoms observed in LD, except for the additional presence of relapsing episodes and the tendency to cause chronic neurological and articular manifestations.

Survey for Tick-Borne Zoonoses in the State of Espirito Santo, Southeastern Brazil

“…† Previously reported data. 45 Agents investigated To exclude the possibility of a cross-reaction between Borrelia spp. and Leptospira spp., these canine serum samples were also tested by serology using 23 different serovars of Leptospira sp.…”

“…For these reasons, a new syndrome has been described in the country. 45 Interestingly, a relapsing fever-like spirochete, namely Borrelia brasiliensis, has been isolated in southern Brazil from Ornithodoros brasiliensis , a soft tick locally known as the "dog tick." 46 It is possible that soft ticks, yet to be documented in the areas of this study, have vectored relapsing fever spirochetes to dogs, contributing to the canine spirochetal reactivity.…”

Chronic unremitting headache associated with Lyme disease-like illness

“…It differs from LD in that to date its etiological agent has not been isolated, its vector does not belong to the Ixodes ricinus complex, and its clinical symptoms are often recurrent 6,10,11 . Researchers from LIM-17 HCFMUSP believe that geographic conditions and ecological biodiversity in Brazil favored the evolution of spirochetes with atypical morphologies adapted for survival in Brazilian vertebrate and invertebrate hosts 6 .…”

“…Researchers from LIM-17 HCFMUSP believe that geographic conditions and ecological biodiversity in Brazil favored the evolution of spirochetes with atypical morphologies adapted for survival in Brazilian vertebrate and invertebrate hosts 6 . Borrelias with atypical morphologies tend to survive inside host cells and become resistant to antibiotics and antibodies, explaining the occurrence of relapsing symptoms and low immune reactivity to B. burgdorferi sensu lato antigens 5,[9][10][11] . These BLDLI peculiarities explain why Brazilian patients usually do not meet the Centers for Disease Control and Prevention (CDC) criteria for serologic diagnosis of LD.…”

“…In the secondary stage of the disease, arthritis and neuropathy are observed in 35%, and cardiac manifestation in 5% 6 . Relapsing episodes are found in almost 75% of the situations when patients are diagnosed in the late stage of the disease (more than three months after disease onset) even after antibiotic treatment 6,10,11 . Both patients reported here came to the service with previous EM, arthritis, and positive serology for B. burgdorferi.…”