&lt;b&gt;&lt;i&gt;Borrelia&lt;/i&gt;&lt;/b&gt; Ocular Infection: A Case Report and a Systematic Review of Published Cases

Lindström, Björn Erik; Skogman, Barbro H.; Lindström, Annika; Tallstedt, Leif; Nilsson, Kenneth

doi:10.1159/000521307

Cited by 6 publications

(5 citation statements)

References 44 publications

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“…Topical treatments also involve intravitreal injections of vancomycin, ceftazidime, moxifloxacin, oxacillin, cefazolin, clindamycin, erythromycin, and ampicillin. This topical treatment can be supplemented with intravenous administration to prolong the antibiotic’s action [ 73 ].…”

Section: Resultsmentioning

confidence: 99%

Diagnosis and Treatment of Uveitis in Children: A Summary of the Latest Data from a 5-Year Literature Review (2018–2023)

Modrzejewska,

Zdanowska

2024

JCM

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Pediatric uveitis has a low incidence. It is very diverse in its presentation and is often the first sign of a severe systemic disease. The pediatric population poses a special therapeutic and diagnostic challenge due to the potentially adverse effects of therapeutic agents on the young body and difficult cooperation with the patient during the examination, as well as the increased risk of complications that can lead to severe disability. The most commonly diagnosed type of uveitis is non-infectious, with first-line therapy consisting of systemic corticosteroids followed by disease-modifying drugs (methotrexate (MTX), mycophenolate mofetil (MMF), and cyclosporin A (CsA)). In severe, refractory cases, biologic therapy is used. The authors reviewed the current literature on the etiology, diagnostic tools, and treatment of uveitis in the pediatric population covering the years 2018–2023, presenting current methods of modern diagnosis and treatment. The reason for writing this article was the need to update the knowledge on uveitis, driven by the increasing prevalence of autoimmune uveitis in the pediatric population. This trend presents significant challenges in diagnosing and treating the disease, as well as managing its complications. Correctly identifying the pathogenetic factor of uveitis can facilitate the diagnosis of the systemic disease underlying the ocular infection and enable the timely implementation of systemic treatment. Furthermore, the emergence of new diagnostic methods necessitates a revision and update of ophthalmic knowledge, essential for both ophthalmologists and other specialists involved in the treatment of uveitis.

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Section: Resultsmentioning

confidence: 99%

Diagnosis and Treatment of Uveitis in Children: A Summary of the Latest Data from a 5-Year Literature Review (2018–2023)

Modrzejewska,

Zdanowska

2024

JCM

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“…The diagnosis should include other manifestations of a Borrelia infection, such as EM or lymphocytoma, and other explanations for cardiac abnormalities should be excluded [10]. Eye involvement has recently been reviewed in a systematic literature review, which found 11 studies [27]. Different parts of the eye can be inflamed, leading to conjunctivitis, keratitis, and/or uveitis, among others, and the diagnosis should be confirmed by PCR via aspirations or biopsies if possible [10,27].…”

Section: Other Rare Manifestations Of Lyme Borreliosismentioning

confidence: 99%

“…Eye involvement has recently been reviewed in a systematic literature review, which found 11 studies [27]. Different parts of the eye can be inflamed, leading to conjunctivitis, keratitis, and/or uveitis, among others, and the diagnosis should be confirmed by PCR via aspirations or biopsies if possible [10,27].…”

Section: Other Rare Manifestations Of Lyme Borreliosismentioning

confidence: 99%

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Tick-borne diseases and the central nervous system : clinical and immunological aspects

Gyllemark

2023

Linköping University Medical Dissertations

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Lyme neuroborreliosis (LNB) is the dominating form of disseminated infection by the tick-borne bacteria Borrelia (B.) burgdorferi in Sweden as well as in Europe. The diagnosis of the manifestation is based on typical symptoms, together with elevated mononuclear cell count in the cerebrospinal fluid (CSF) and elevated levels of Borrelia-specific antibodies in the CSF. The diagnostic arsenal has, in recent years, been complemented by analysis of the chemokine CXCL13 in the CSF, with increasing levels in the early phase of the disease, even before antibodies can be detected in the CSF. Most patients recover within a couple of months after antibiotic treatment, but a few can suffer from residual symptoms. The mechanisms behind this are still puzzling, but there are indications that the host´s immune response may play a role. Prognostic markers would be desirable and increased understanding of pathogenetic mechanisms may provide a basis for development of new treatment strategies. Other agents besides B. burgdorferi have, however, also been detected in ticks collected in Sweden, but the knowledge of their impact on human health and their ability to invade the central nervous system (CNS) is limited.The aims of this thesis were to investigate a set of cytokines and chemokines associated with Th1 (CXCL10), Th2 (CCL22), Th17 (IL-17A, CXCL1, CCL20) and B cell (APRIL, BAFF, CXCL13) -related immunity and its association with recovery in patients with LNB included both retrospectively and prospectively. The chemokine CXCL13 was further analysed, comparing the performance of two different diagnostic methods. In a large cohort of patients investigated for LNB we investigated signs of other tick-borne diseases by analysing serum and CSF using both molecular and serological techniques.In the retrospective cytokine/chemokine study, all investigated cytokines and chemokines; namely, APRIL, BAFF, CXCL13, IL-17A, CXCL1, and CCL20 could be detected at elevated levels in patients with LNB compared to controls. Patients with recovery > 3 months had higher levels of APRIL, BAFF, and IL-17A. In the prospective study, patients with short recovery (< 1 month) had lower levels of CCL20 and patients with prolonged recovery (> 6 months) had higher levels of IL-17A. The analysis of the chemokine CXCL13 with both an enzyme-linked immunosorbent assay (ELISA) with a best-performanced cut-off of 56 pg/mL and bead-based (Luminex) method with a best-performance cut-off of 158 pg/mL (both assays with 100% sensitivity and specificity) displayed the importance of different cut-offs depending on which method that is used.In 600 patients, we analysed serum and CSF with PCR for the different tick-borne agents Anaplasma phagocytophilum, B. burgdorfer spp. (including B. miyamotoi), Neoehrlichia (N.) mikurensis, Rickettsia spp., Babesia spp. and tick-borne encephalitis virus. N. mikurensis and B. burgdorferi could be detected by PCR in sera from two patients. Neither PCR, nor serological analysis could detect any potential co-infections.In conclusion, we ca...

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“…Etyolojik özelliklere göre idiyopatik, enfeksiyöz ve enfeksiyon dışı nedenler; anatomik olarak ön, arka, pars planit (orta) ve pan-üveit; histopatolojik özelliklerine göre granülamatöz ve non-granülomatöz olarak sınıflandırılır. 4 Çocukluk çağında üveitin en sık nedeni idiyopatiktir; ancak enfeksiyöz hastalıklar, [5][6][7][8] romatolojik hastalıklar, 9 primer göz hastalıkları ve ilaçlara bağlı olarak da üveit görülebilir. 10 Üveit konusunda uzmanlaşmış göz doktorlarının çoğu genellikle enfeksiyöz ve primer göz hastalıkları nedenlerini belirleyebilir, ancak altta yatan bir romatolojik hastalık için hastaların muhakkak çocuk romatoloji hekimi tarafından değerlendirilmesi gerekmektedir.…”

Section: Introductionunclassified

Üveit İle Başvuran Hastaların Demografik ve Klinik Verileri: Tek Merkez Deneyimi

BAYRAK,

ŞAHİN,

ÖNDER TOKUÇ

et al. 2024

Acta Medica Nicomedia

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Çocuk romatoloji polikliniğine başvuran üveit tanılı hastaların etyolojik faktörlerinin dağılımının değerlendirilmesini amaçladık. Yöntem: Ağustos 2020-Mart 2023 arasında üveit tanısı alan olguların klinik özellikleri, laboratuvar ve immünolojik test verileri, enfeksiyon belirteçleri ve tedavi yanıtları geriye dönük olarak incelendi. Bulgular: Çalışmaya 60 hasta dahil edildi. Hastaların 26’sı (%43) kız, 34’ü (%57) ise erkekti. Hastaların ortanca yaşı 160 (23-240), semptom başlama yaşı 136 (16-204), tanı yaşı 136 (18-216) aydı. Gözde kızarıklık (%73) en sık başvuru şikayetiydi. Üveit lokalizasyonu sırasıyla; anterior (ön) (%59), posterior (arka) (%16), pan-üveit (%16) ve pars planitti (%9). Hastaların 12’si (%20) enfeksiyöz üveitti. Enfeksiyöz dışı üveit nedenleri ise sırasıyla; idiyopatik (%81), Behçet hastalığı (%8), juvenil idiopatik artrit (%8) ve tübülointerstisyel nefrit ve üveit sendromuydu (%2). Yirmi bir hastada (%35) ANA değeri pozitif olarak saptandı. HLA-B27 pozitifliği %14 idi. Kırk beş hastaya (%75) tedavi lokal steroid tedavisi uygulandı. Diğer uygulanan tedaviler sırasıyla; sistemik steroid (30,%50 hasta), DMARD (29, %48,3 hasta) ve biyolojik ajandı (16, %26,7 hasta). Uygulanan tedaviler sonrasında 26 (%43,3) hasta tedavisiz remisyonda idi. Dokuz hasta takibi bırakmıştı. Yirmi beş hastanın ilaçla takibine devam etmekteydi. Takipte 2 hastada glokom gelişmişti, 2 hasta katarakt ve 2 hasta da posterior sineşi nedeni ile opere olmuştu. Sonuç: Kliniğimizde 60 üveit tanılı hasta incelendi. En sık neden idiyopatik iken, enfeksiyöz hastalıklar içinde en sık etken kedi tırmığı idi. Çocuk romatoloji hekimlerinin sık sık karşısına çıkan üveit kalıcı görme kaybına neden olabilen önemli bir hastalıktır. Referans merkez olan kliniğimizdeki tecrübeler bu hastalarla günlük pratiğinde uğraşan çocuk ve çocuk romatoloji hekimlerine bir yol haritası çizebilir.

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<b><i>Borrelia</i></b> Ocular Infection: A Case Report and a Systematic Review of Published Cases

Cited by 6 publications

References 44 publications

Diagnosis and Treatment of Uveitis in Children: A Summary of the Latest Data from a 5-Year Literature Review (2018–2023)

Diagnosis and Treatment of Uveitis in Children: A Summary of the Latest Data from a 5-Year Literature Review (2018–2023)

Tick-borne diseases and the central nervous system : clinical and immunological aspects

Üveit İle Başvuran Hastaların Demografik ve Klinik Verileri: Tek Merkez Deneyimi

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