Clinical management of Lyme borreliosis

Weber, Karin; Hw, Pfister

doi:10.1016/s0140-6736(94)90131-7

Cited by 50 publications

(24 citation statements)

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“…In general, the clinical symptoms of Lyme disease vary from an acute skin rash (erythema chronicum migrans) to severe arthritic, neurologic, and dermatologic manifestations (41). In addition, the disease appears to progress to neurologic and dermatologic manifestations more frequently in Europe, whereas arthritis is the more common late manifestation in the United States (7,19,40).…”

mentioning

confidence: 99%

PCR-Reverse Line Blot Typing Method Underscores the Genomic Heterogeneity of Borrelia valaisiana Species and Suggests Its Potential Involvement in Lyme Disease

Godfroid

Humair

et al. 2003

J Clin Microbiol

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Detection of the Borrelia burgdorferi sensu lato complex in biological samples is currently done by conventional immunological and molecular biological methods. To improve on the accuracy of these methods and to simplify the procedure for testing large numbers of samples, a solid-phase sandwich hybridization system readily applicable to the detection of PCR products has been designed. This colorimetric detection system relies on the use of polybiotinylated detection probes and of specific capture oligonucleotides covalently linked at allocated positions on nylon membrane strips. From a phylogenetic analysis on a great number of ospA gene sequences, we have designed and synthesized a set of PCR primers specific to the five Borrelia burgdorferi sensu lato genospecies present in Europe and a subset of probes (capture and detection probes) specific to these five genospecies (B. burgdorferi sensu stricto, B. garinii, B. afzelii, B. valaisiana, and B. lusitaniae). This combined PCR hybridization system was evaluated with a large number of various B. burgdorferi isolates and clinical specimens. These analyses clearly showed that the system could be used as a typing method to distinguish five genospecies belonging to the B. burgdorferi sensu lato complex. In addition, the study showed that B. valaisiana strains might be more heterologous than suspected up to now and clustered into three genomic groups.

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mentioning

confidence: 99%

PCR-Reverse Line Blot Typing Method Underscores the Genomic Heterogeneity of Borrelia valaisiana Species and Suggests Its Potential Involvement in Lyme Disease

Godfroid

Humair

et al. 2003

J Clin Microbiol

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“…After the first visit, the patients were usually followed for 3–12 months, sometimes for years. All patients with established EM received systemic antibiotic treatment [4,12,13,14,15]. …”

Section: Methodsmentioning

confidence: 99%

Mini Erythema Migrans – A Sign of Early Lyme Borreliosis

Weber¹,

Wilske

2006

Dermatology

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Background: An erythema migrans (EM) remaining smaller than 5 cm in diameter, called mini EM by us, has not been addressed in detail. Objective: To study the significance of the mini EM as a sign of Lyme borreliosis. Methods: Patients with suspected mini EM were retrospectively selected out of 257 consecutive patients with EM. The diagnosis of mini EM rested on the cultivation of Borrelia burgdorferi. Species and subtype analysis of culture isolates was performed using outer surface protein A (OspA) polymerase chain reaction followed by restriction fragment length polymorphism and sequencing of the OspA gene. Results: There was one patient with definite (0.4%) and another patient with a questionable mini EM. Borrelia garinii OspA type 6 was identified in the patient with the definite and B. burgdorferi sensulato in the patient with the questionable mini EM. Conclusion: The mini EM represents an important and apparently uncommon sign of early Lyme borreliosis.

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“…Despite spontaneous clearance of EM in weeks to months in most cases (Weber and Neubert, 1986;Weber and Pfister, 1994), adequate treatment is mandatory in all patients, since viable B. burgdorferi sensu lato can remain in the skin in untreated patients (Kuiper et al, 1994), and secondary cutaneous or extracutaneous manifestations of Lyme borreliosis may result from reactivation and dissemination of the spirochete. Moreover it is not possible to predict the spontaneous course of the infection (e.g., dissemination to the central nervous system) from the clinical appearance or from the presence of absence of associated extracutaneous symptoms (Oksi et al, 2001;Maraspin et al, 2002) The goals of therapy are to eradicate the infection, to clear cutaneous and extracutaneous signs and symptoms, and to prevent progression of Lyme borreliosis.…”

Section: Therapymentioning

confidence: 99%