Ab0903 lyme Arthritis in High Lyme Disease Endemic Europe Zone

Abstract

BackgroundLyme disease is a tick born infectious disease caused by different genospecies of Borrelia bacteria (B. burgdorferi sensu strictu, B. afzelii and B. garinii). Disease clinical manifestation varies and belongs on the variety of Borrelia bacteria genospieces. In America Lyme arthritis dominates, which is caused by B.burgdorferi, while in Europe Lyme disease is caused by Borrelia afzelli or Borrelia garinii (less commonly by Borrelia burgdorferi) leading to usual disease manifestation as erythema migrans or neuroborreliosis. Lyme disease is very common disease in the world, approximately 300,000 people get Lyme disease each year in the United States (Centers for disease control and prevention US), in Lithuania disease frequency is 101.6 cases per 100 000 population (Center for Communicable Diseases and AIDS, Lithuania, 2016 year).ObjectivesTo investigate the frequency of Lyme arthritis in high disease endemic European country Lithuania. To find out with joint was most frequently affected.MethodsA retrospective, single center study was performed. We have analyzed the medical documents of adult patients, who were hospitalized to Infectious disease center (Vilnius, Lithuania), due to severe Lyme disease clinical manifestation, in 2014-2017 years.Results88 patients were enrolled (57 females, 31 males, age range 18-90 years, median age 57 years). Patients were divided into four groups according disease clinical manifestation: erythema migrans, neuroborreliosis, Lyme arthritis and carditis (atrioventricular block). The most frequently erythema migrans was observed (53 cases, 62, 35 percentages (%)), than neuroborreliosis (27 cases, 31, 76 percentages), following by Lyme arthritis (3 cases, 3, 53 percentages) and Lyme carditis (2 cases, 2, 35 percentages). Between Lyme arthritis patients inflamed joints were these: knee (one case), ankle (one case) and both - knee and ankle (one case). In two cases high laboratory markers (ESR 116; 23 mm/h, CRP 125; 50 mg/l) and high body temperature (38, 2; 39, 5 0 t) was documented.Conclusion2.35% of hospitalized Lyme infected patients reveal as Lyme arthritis. Inflamed joint were knee (50%) and ankle (50%). Despite the fact that it is used to think that Lyme arthritis occurs only (mostly) in America we can find it in Europe too, though its incidence is lowReferences[1] Sergamumo užkrečiamomis ligomis Lietuvoje apžvalga 2016. Užkrečiamų ligų ir AIDS centras. 96-98 pages. http://www.ulac.lt/uploads/downloads/leidiniai/Sergamumo_apzvalga_2016.pdf[2] Franc Strle, Gary P. Wormser, Linden T. Hu, John A. Branda, Joppe W. R. Hovius, Xin Li, and Paul S. Mead. Lyme borreliosis. Nat Rev Dis Primers 2, Article number: 16090 (2016).[3] Cardenas-de la Garza, J.A., De la Cruz-Valadez, E., Ocampo-Candiani, J. et al. Eur J Clin Microbiol Infect Dis (2018). https://doi.org/10.1007/s10096-018-3417-1Disclosure of InterestsNone declared