Borrelia burgdorferi infection and Lyme disease in children

Esposito, Susanna; Bosis, Samantha; Sabatini, C; Tagliaferri, L.; Principi, Nicola

doi:10.1016/j.ijid.2012.09.014

Cited by 52 publications

(35 citation statements)

References 44 publications

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“…FUO-like symptoms, which appear 3-4 weeks after Borrelia inoculation, is usually the earliest manifestation, combined with a typical migrating erythema resembling a bull's eye (28). Another frequently unrecognized zoonosis is leptospirosis, having undifferentiated fever as a main manifestation, which has recently developed from an occupational disease of veterinarians, farmers, and other animal handlers to a cause of epidemics in poor urban communities of developing countries (28).…”

Section: Infectionsmentioning

confidence: 99%

A Roadmap for Fever of Unknown Origin in Children

Rigante

Esposito

2013

Int J Immunopathol Pharmacol

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Fever of unknown origin (FUO) in adults is conventionally defined by the occurrence of body temperatures above 38.3°C (101°F) for a period of 3 weeks without any identified etiology after a period of 1-week hospitalization. The issue of FUO in pediatrics is rather hazy and still represents a challenging diagnostic dilemma. Most of the available data are limited to nationwide cohorts of patients of any age. The major difficulty in establishing a diagnosis is that the characteristic features rendering specific disorders clinically recognizable are absent or subtle, hence only a painstaking questioning on family background may elicit the correct investigative path. No diagnostic algorithms are actually available and clinicians must rely on a very careful step-by-step evaluation of the single patient. The need for invasive diagnostic techniques should be closely taken into consideration when laboratory tests or simple imaging procedures fail to discern the origin of FUO. Fevers with no reasonable explanation and no localizing signs often conceal different common diseases in children, which tend to display an unusual or atypical pattern. The principal causes behind FUO in pediatric age remain infections, followed by collagen vascular diseases and neoplastic disorders, although most children with malignancies present other systemic signs or suggestive laboratory abnormalities. The possibility of autoinflammatory syndromes, drug fever, and factitious fever should also be taken into account.

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Section: Infectionsmentioning

confidence: 99%

A Roadmap for Fever of Unknown Origin in Children

Rigante

Esposito

2013

Int J Immunopathol Pharmacol

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“…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].…”

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confidence: 99%

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

Bil‐Lula¹,

Matuszek²,

Woźniak³

2015

Adv Clin Exp Med

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Background. Infections of Borrelia burgdorferi sensu lato reveal clinical manifestations affecting numerous organs and tissues. The standard diagnostic procedure of these infections is quite simple if a positive history of tick exposure or typical erythema migrans appears. Lack of unequivocal clinical symptoms creates the necessity for further evaluation with laboratory tests. Objectives. This study discusses the utility of a novel, improved, well-optimized, sensitive and highly specific quantitative real-time PCR assay for the diagnostics of infections caused by Borrelia burgdorferi sensu lato. Material and Methods. We designed an improved, specific, highly sensitive real-time quantitative polymerase chain reaction (RQ-PCR) assay for the detection and quantification of all Borrelia burgdorferi genotypes. A wide validation effort was undertaken to ensure confidence in the highly sensitive and specific detection of B. burgdorferi. Results. Due to high sensitivity and great specificity, as low as 1.6 × 10² copies of Borrelia per mL of whole blood could be detected. As much as 12 (3%) negative ELISA IgM results, 14 (2.8%) negative results of Line blot IgM, 11 (3.1%) and 7 (2.7%) of negative ELISA IgG and Line blot IgG results, respectively, were positive in real-time PCR. Conclusions. The data in this study confirms the high positive predictive value of real-time PCR test in the detection of Borrelia infections (Adv Clin Exp Med 2015, 24, 4, 663-670).

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“…Symptomatic history can extend for years. Pediatric LD has extensive similarities to adult forms of the condition (except for meningopolyradiculoneuritis and acrodermatitis chronica atrophicans, which are typically not seen in children) as noted in a comparative review by Esposito and co-authors 30 . A very comprehensive set of guidelines for LD diagnosis and management (2010) is available from Deutsche Borreliose-Gesellschaft, the German Borreliose Society and adequately sets out the spectrum of the disease and its management.…”

Section: Clinical Features-systemicmentioning

confidence: 91%

Morgellons: a novel dermatological perspective as the multisystem infective disease borreliosis

Mayne¹,

English

Kilbane

et al. 2013

F1000Res

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Morgellons disease (MD) is a term that has been used in the last decade to describe filaments that can be found in human epidermis. It is the subject of considerable debate within the medical profession and is often labeled as delusions of parasitosis or dermatitis artefacta. This view is challenged by recent published scientific data put forward between 2011-2013 identifying the filaments found in MD as keratin and collagen based and furthermore associated with spirochetal infection. The novel model of the dermopathy put forward by those authors is further described and, in particular, presented as a dermal manifestation of the multi-system disease complex borreliosis otherwise called Lyme disease. A differential diagnosis is drawn from a dermatological perspective. The requirements for a diagnosis of delusional disorder from a psychiatric perspective are clarified and the psychological or psychiatric co-morbidity that can be found with MD cases is presented. A concurrent case incidence is also included. Management of the multisytem disease complex is discussed both in general and from a dermatological perspective. Finally replacement of the term 'Morgellons' by 'borrelial dermatitis' is proposed within the profession.

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Borrelia burgdorferi infection and Lyme disease in children

Cited by 52 publications

References 44 publications

A Roadmap for Fever of Unknown Origin in Children

A Roadmap for Fever of Unknown Origin in Children

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

Morgellons: a novel dermatological perspective as the multisystem infective disease borreliosis

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