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Bacteria
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
A disease first diagnosed in Lyme, Connecticut, United States, in 1975 is caused by a microaerophilic spirochete, Borrelia burgdorferi. Lyme disease is transmitted by the deer tick and is presently the most common vector-borne infection in the U.S., having been diagnosed in all fifty states. It has been recognized as well in several countries in Europe and Asia. The infection is characterized by a distinctive annular skin rash at the site of the tick′s bite accompanied by fever and joint pain although Borrelia species do not produce any known toxins. From the site of the tick bite, the infection progresses over weeks to months to the nervous system, heart, and large joints, especially the knee where it produces an arthritic condition. The organism is sensitive to amoxicillin, ceftriaxone, doxycillin, erythromycin, and penicillin but resists metronidazole.
Laboratory Diagnostic Tests in the Evaluation of Fever
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
The species of Borrelia responsible for relapsing fever are generally identified on examination of thick smears of peripheral blood. A small drop of blood is applied to a clean glass slide and spread in a circular manner to a diameter of approximately 1 cm. Giemsa, Wright, Leishman, or other routine stains are adequate. Inoculation of clinical material into chick embryo or suckling rodents is a sensitive test, but rarely performed nowadays.
Ticks
Published in Gail Miriam Moraru, Jerome Goddard, The Goddard Guide to Arthropods of Medical Importance, Seventh Edition, 2019
Gail Miriam Moraru, Jerome Goddard
Other tick species may be involved in the ecology of Lyme borreliosis in the United States. Also, there may be several, as yet undescribed, Borrelia species that cause Lyme-like illness, such as one recently described.25 In the southern United States, there have been reports for years about an LB-like illness of unknown etiology which has associated EM lesions.26 The Centers for Disease Control and Prevention (CDC) often just classifies these cases as southern tick-associated rash illness (STARI) (see text box).
How relevant are in vitro culture models for study of tick-pathogen interactions?
Published in Pathogens and Global Health, 2021
Cristiano Salata, Sara Moutailler, Houssam Attoui, Erich Zweygarth, Lygia Decker, Lesley Bell-Sakyi
Unlike the aforementioned bacterial genera, Borrelia spp. spirochetes, causative agents of Lyme borreliosis and relapsing fever, are predominantly extracellular, living within the tick midgut lumen and hemocoel. Tick cells are not essential for replication, but form a substrate for anchorage and can be used to study spirochete-cell interactions in vitro. The Borrelia burgdorferi sensu stricto outer surface protein A (OspA) plays an important role in attachment of spirochetes to tick midgut cells [157]; B. burgdorferi s.s. spirochetes co-cultivated with vector tick (ISE6) cells at temperatures between 31°C and 37°C showed a greater reduction in OspA expression with increasing temperature than spirochetes grown axenically [158]. In contrast, expression of the B. burgdorferi outer surface protein C (OspC), upregulated during transmission tick feeding [159], increased with temperature in spirochetes co-cultivated with tick cells while remaining unchanged in axenic cultures [160]. The first study to demonstrate that B. burgdorferi s.s. has a functional stringent response, enabling it to respond to situations of nutrient depletion or starvation encountered in unfed, host-seeking ticks [160], was carried out in vector (IDE8 and ISE6) cell lines [161].
Serological testing for Lyme Borreliosis in general practice: A qualitative study among Dutch general practitioners
Published in European Journal of General Practice, 2020
Tjitske M. Vreugdenhil, Mariska Leeflang, Joppe W. Hovius, Hein Sprong, Jettie Bont, C. W. Ang, Jeanette Pols, Henk C. P. M. Van Weert
Diagnosis of LB is straightforward in patients with classic EM, as the typical annular rash is pathognomonic. Recognising disseminated LB is more difficult because it may mimic other more frequently occurring diseases, for example, Bell’s palsy. Diagnosis of disseminated LB is based on clinical symptoms and a history of a tick bite, confirmed by serological testing. The accuracy of the commonly used serological tests depends on the stage of the disease. The sensitivity ranges from approximately 50% in patients with EM to 77% in patients with neuroborreliosis and 97% in patients with acrodermatitis chronica atrophicans [6]. The specificity is approximately 80% in clinical practice and 95% in healthy controls, due to cross-reactivity and persisting antibodies after a resolved Borrelia infection. Discrimination between active and resolved infections based on test results may be difficult [8].
Breast implant causes allergic contact dermatitis or foreign body reaction?
Published in Case Reports in Plastic Surgery and Hand Surgery, 2020
Hilde M. Bosker, Jorrit B. Terra, Martin M. Stenekes
Our differential diagnosis consisted of erythema chronicum migrans, morphea, allergic contact dermatitis and a granulomatous (foreign body) reaction. An ultrasound showed nothing unusual. Laboratory results showed e.g. erythrocyte sedimentation rate (ESR; 40), Hb (8.4), leukocytes (6.4) and alanine aminotransferase (ALAT; 19). The biopsy showed a superficial and deep perivascular dermatitis consisting of mainly lymphocytes and plasma cells (see Figure 2). The polymerase chain reaction (PCR) on the fresh biopsy was negative for Borrelia as was Borrelia serology. Furthermore, the safety sheets (SDS) of the permanent tissue expander were requested and patch tests were performed with our extended European Baseline series, cosmetics series, fragrance series, metal series, plastic glues series and the acrylates series. The patient only reacted positive to hydroperoxides of limonene which was considered to be irrelevant.