Early Lyme Borreliosis in Patients Treated with Tumour Necrosis Factor-Alfa Inhibitors

Maraspin, Vera; Bogovič, Petra; Rojko, Tereza; Ogrinc, Katarina; Ružić‐Sabljić, Eva; Strle, Franc

doi:10.3390/jcm8111857

Cited by 8 publications

(3 citation statements)

References 35 publications

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“…In our series patients did not report any comorbidity, despite a mild atopy in patient 1. Nevertheless, it is possible that coexistent comorbid conditions in pregnant women could alter the course of LB even if treated, as shown in immunocompromised patients ( 42 ). Nevertheless, at present there are no reports describing the course of LB and outcome in pregnant women with comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Lyme Borreliosis and Pregnancy - Our Experience

et al. 2022

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Lyme Borreliosis (LB) is an infection transmitted by Ixodes sp. ticks. Its early manifestation includes erythema migrans rash. Since the discovery of LB in 1975, the question arose as to whether this infection could be vertically transmitted from mother to fetus during pregnancy, as transplacental transmission has already been known for other spirochetoses, such as syphilis, relapsing fever and leptospirosis. The first confirmed case with positive Lyme serology was described in 1985 in a 28-year- old mother who had acquired Lyme in the first trimester and then developed an erythema migrans rash. Subsequently, transmission of Borrelia burgdorferi sl. in humans from mother to fetus has been documented through identification of Borrelia spirochetes in fetal tissues/and or placenta by various methods including culture, PCR and indirect immunofluorescence. Adverse birth outcomes, which are limited in case of prompt LB treatment, included spontaneous miscarriage, preterm birth and hyperbilirubinemia, but also cardiac involvement and cutaneous angiomas have been documented although rarely. No significant associations were found between adverse outcomes at birth and the trimester of infection. Patients treated for gestational LB had a lower frequency of miscarriages and premature births, as also the frequency of congenital malformations was similar to that observed in the normal population. The recommended treatment for LB in pregnancy is Amoxicillin, 1 g 3 times a day for 14–21 days. In the present study, we report our case series, which includes 11 pregnant women, 6 of which developed erythema migrans during pregnancy (between week 8 and 34), 3 had myoarticular or neurological symptoms and 2 had positive serology, but did not develop any clinical symptoms. Our data stress on the importance of early antibiotic treatment also in seropositive gestating women without symptoms in order to avoid any possible complication to fetus and newborns.

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Section: Discussionmentioning

confidence: 99%

Case Report: Lyme Borreliosis and Pregnancy - Our Experience

et al. 2022

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“…To test for the presence of Borrelia in skin, a 3 mm punch biopsy was obtained from the expanding edge of the EM after local anesthesia, as reported elsewhere [ 7 ]. The skin biopsy specimen was immediately inoculated into a 10 mL tube with a modified Kelly-Pettenkofer (MKP) medium.…”

Section: Methodsmentioning

confidence: 99%

Microbiologic Findings in a Cohort of Patients with Erythema Migrans

Ružić-Sabljić,

Maraspin,

Bogovič

et al. 2024

Microorganisms

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Erythema migrans (EM) is the initial and the most frequent clinical manifestation of Lyme borreliosis (LB). Herein, we report on the capacity of culture and serology for the demonstration of Borrelia infection in a cohort of 292 patients diagnosed with typical EM at a single medical center. The median duration of EM at diagnosis was 12 days, and the largest diameter was 16 cm; 252 (86.3%) patients presented with solitary EM, whereas 40 (13.7%) had multiple EM. A total of 95/292 (32.5%) patients had positive IgM, and 169 (57.9%) had positive IgG serum antibodies; the Borrelia isolation rate was 182/292 (62.3%). The most frequent species by far was B. afzelii (142/148, 95.9%) while B. garinii (2.7%) and B. burgdorferi s.s. (1.4%) were rare. IgM seropositivity was associated with a younger age, multiple EM and the absence of underlying chronic illness; IgG seropositivity was associated with the duration of EM at diagnosis, the diameter of the EM, having had a previous episode of LB and the absence of symptoms at the site of the EM. Furthermore, the Borrelia isolation rate was statistically significantly lower in patients with positive Borrelia IgM antibodies. Although microbiologic analyses are not needed for the diagnosis of typical EM, they enable insights into the etiology and dynamics of the immune response in the course of early LB.

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“…На сегодняшний день отсутствуют данные о том, что БЛ, развившаяся во время беременности, приводит к врождённой инфекции или синдрому врождённых аномалий плода, в связи с чем выходящее за рамки стандартных схем дополнительное лечение или наблюдение за матерью или ребёнком не рекомендуется. Пациенты с ослабленной иммунной системой успешно лечились от БЛ с использованием схем, изученных на исходно здоровом макроорганизме [5][6][7].…”

Section: Introductionunclassified

Lyme disease: modern approaches to treatment and prevention (based on international recommendations of 2020)

Белов

Ananyeva

2022

A&Ch

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Lyme disease (LD) or tick-borne borreliosis affects thousands of people every year in different regions of the world, primarily in the United States and Europe. Given the great social and medical importance of this problem, an updated version of the clinical guidelines for the prevention, diagnosis and treatment of PD was published in November 2020 by a committee of experts of the Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN) and the American College of Rheumatology (ACR). This article discusses the main issues of the use of antibacterial drugs in LD. The most commonly used medications are doxycycline, amoxicillin, cefuroxime axetil, and ceftriaxone. Patients with erythema migrans receive appropriate antibiotics for 7–14 days, depending on the medication used. In case of other clinical manifestations of LD, the duration of treatment is extended to 14–28 days. Antibiotic prophylaxis is carried out using a single oral dose of 200 mg doxycycline for adults and 4.4 mg/kg (with a maximum of 200 mg) for children. This treatment scheme is highly efficient, easy to administer, and has a relatively low risk of adverse events.

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Early Lyme Borreliosis in Patients Treated with Tumour Necrosis Factor-Alfa Inhibitors

Cited by 8 publications

References 35 publications

Case Report: Lyme Borreliosis and Pregnancy - Our Experience

Case Report: Lyme Borreliosis and Pregnancy - Our Experience

Microbiologic Findings in a Cohort of Patients with Erythema Migrans

Lyme disease: modern approaches to treatment and prevention (based on international recommendations of 2020)

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