Clinical Features of 705Borrelia burgdorferiSeropositive Patients in an Endemic Area of Northern Italy

Abstract

Background. Lyme Borreliosis is a multisystemic infection caused by spirochetes of Borrelia burgdorferi sensu lato complex. The features of Lyme Borreliosis may differ in the various geographical areas, primarily between the manifestations found in America and those found in Europe and Asia. Objective. to describe the clinical features of Lyme Borreliosis in an endemic geographic area such as Friuli-Venezia Giulia in the Northeastern part of Italy. Methods. The medical records of patients resulted seropositive for Borrelia burgdorferi have been retrospectively recorded and analyzed. Results. Seven hundred and five patients met the inclusion criteria, 363 males and 342 females. Erythema migrans was the most common manifestation, detected in 437 patients. Other classical cutaneous manifestations included 58 cases of multiple erythema migrans, 7 lymphadenosis benigna cutis, and 18 acrodermatitis chronica atrophicans. The musculoskeletal system was involved in 511 patients. Four hundred and sixty patients presented a neurological involvement. Flu-like symptoms preceded or accompanied or were the only clinical feature in 119 patients. Comments. The manifestations of Lyme borreliosis recorded in this study are similar to the ones of other endemic areas in Europe, even if there are some peculiar features which are different from those reported in Northern Europe and in the USA.

Reticulate Truncal Erythema in Early Disseminated Cutaneous Borreliosis

“…Other rare cutaneous manifestations include morphea, lichen sclerosus, cutaneous B-cell lymphoma, granuloma annulare, interstitial granulomatous dermatitis, cutaneous sarcoid-like reaction, necrobiosis lipoidica, and necrobiotic xanthogranuloma [8]. Multiple erythema migrans or erythema multiforme-like lesions have been occasionally observed and interpreted as a sign of hematological spread of spirochetes [9,10]. We suggest the same in our patient.…”

Lyme Borreliosis - the Utility of Improved Real-Time PCR Assay in Detection of Borrelia burgdorferi Infections

“…It is caused by the bite of a Ixodes ricinus complex tick infected with Borrelia burgdorferi sensu lato [2]. Infections of Borrelia burgdorferi sensu lato reveal clinical manifestations affecting numerous organs and tissues, dependent on the different species of Borrelia [3][4][5][6]. The group of spirochetes, usually called Borrelia burgdorferi sensu lato, includes 11 different genospecies, from which 3 are frequently observed in Europe: B. burgdorferi sensu stricto, Borrelia afzelii and Borrelia garinii [7,8].…”

Impact of Co-Infections in Lyme Disease

“…However, LD itself in small percentage (about 10%) can present with fever, chills and headache. Such an epidemiologic report is confirmed also in Europe: in an Italian study conducted on more than 700 people living in an endemic area for LD, flu-like symptoms as fever, myalgia and headache preceded, accompanied or were the only clinical sign of LD in 16.88% of patients [35].…”