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Pathophysiology
Published in Ibrahim Natalwala, Ammar Natalwala, E Glucksman, MCQs in Neurology and Neurosurgery for Medical Students, 2022
Ibrahim Natalwala, Ammar Natalwala, E Glucksman
i – Borrelia burgdorferi is a bacterium that causes Lyme disease. It is transmitted by ticks and presents with erythema chronicum migrans (expanding ‘bullseye’ red rash) and flu-like symptoms in its initial stages. In its later stages, patients may experience a migratory polyarthritis and bilateral Bell’s palsy. Doxycycline, which is a tetracycline, is indicated for the treatment of Lyme disease.15
An Overview of Microbes Pathogenic for Humans
Published in Nancy Khardori, Bench to Bedside, 2018
Eric Lehrer, James Radike, Nancy Khardori
Borrelia burgdorferi is the bacteria responsible for Lyme disease, a tick-borne illness. There are three distinct clinical stages of Lyme disease; early localized disease is characterized by the presence of the ubiquitous targetoid skin lesion, erythema migrans (EM) and constitutional symptoms may be present. These present within 1 month following the tick bite. Early disseminated disease is characterized by multiple EM lesions and neurologic and/or cardiac abnormalities seen weeks to months after the tick bite. Finally, late Lyme disease is associated with arthritis and neurologic symptoms. Lyme disease is transmitted by the Ixodes tick, and both deer and mice serve as the main animal reservoirs. It is endemic in the northeastern and midwestern parts of the United States, as well as parts of Asia and Europe.
Biology and Distribution of Ticks of Medical Importance
Published in Jürg Meier, Julian White, Handbook of: Clinical Toxicology of Animal Venoms and Poisons, 2017
André Aeschlimann, Thierry A. Freyvogel
Unicellular parasites, including microorganisms, are transmitted by and large via the salivary glands. Spirochaetes transmitted by Argasidae may also use the route of the coxal glands. Borrelia burgdorferi may possibly be regurgitated. Coxiella burnetti, a rikettsia-like bacterium, is excreted with the tick’s faeces and later inhaled into the lungs; this is an example of what is known as the stercoral route. As for filariae, their stage 3 larvae leave the tick actively, breaking through the integument and invading the final host by penetrating through the skin at the site of the lesion made by the tick rostrum.
Lyme disease in Western Europe: an emerging problem? A systematic review
Published in Acta Clinica Belgica, 2021
Olivia Vandekerckhove, Emmy De Buck, Eric Van Wijngaerden
Potential explanations for the increase of LB suggested in previous studies included social, ecological and technological factors that act synergistically [9]. First of all, social factors such as enhanced human mobility including tourism and increasing outdoor activities, as well as increased residence in rural areas make exposure to tick bites more likely. Secondly, a milder climate due to global warming enabled ticks to spread into higher latitudes and altitudes in many countries [4]. Milder winters also prolong seasonal tick activity. Thirdly, technological factors can create a false idea of LB emergence. Enhanced diagnostic techniques, as well as increased awareness among patients and physicians with more precise case-history recording and subsequent laboratory investigation, can contribute to an increased amount of LB diagnoses reported. For example, in Belgium incidence of laboratory-confirmed LB seemed to have risen over a 25-year period with a peak in 2002 [14], yet in 2015 the NRC performed 3091 tests whereas 2 years before only 2468 tests were performed. The increase of positive serologic tests for Borrelia burgdorferi could be explained by an increase of the number of tests performed [14]. Therefore, this could be an overestimation of true emergence of LB due to enhanced testing. The non-uniform surveillance of LB in Western-European countries as described above could also play a role in the observed emergence of LB, for previous underreporting could be corrected by enhanced monitoring.
Assessment of TLR-2 concentration in tick-borne encephalitis and neuroborreliosis
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2019
Anna Moniuszko-Malinowska, Paweł Penza, Piotr Czupryna, Olga Zajkowska, Sławomir Pancewicz, Monika Król, Renata Świerzbińska, Justyna Dunaj, Joanna Zajkowska
The role of TLR-2 has not been analyzed neither in the course of TBE nor in neuroborreliosis (NB). There have been only a few experimental studies on Borrelia burgdorferi infection. Lieskovska et al. [4] proved that tick saliva interferes with several signalling pathways activated by TLR-2 ligand and B. afzelii in dendritic cells. Hirschfeld et al. [5] observed that TLR-2 is robustly activated by B. lipoproteins. TLRs have an essential role in the control of B. burgdorferi burden, because mice deficient in the common TLR signaling molecule, myeloid differentiation primary response 88 (MyD88), have up to 250-fold more spirochetes than the wild-type controls [6,7]. Finding differences in the concentration of TLR-2 in the acute phases of these diseases could contribute not only to expansion of knowledge on the pathogenesis of both diseases, but also may be useful in the differential diagnosis.
Lichen sclerosus associated with Nd:YAG laser therapy
Published in Journal of Cosmetic and Laser Therapy, 2019
Seher Bostanci, Bengu Nisa Akay, Pelin Ertop, Seçil Vural, Aylin Okcu Heper
A 43-years-old woman with color change in genital area was admitted to our clinic. Medical history revealed type II diabetes mellitus (DM) and Hashimoto thyroiditis. The patient had six sessions of whole body laser assisted hair removal with long pulsed 1064 nm Nd:YAG laser in last 2 years. Lesions had developed 2 weeks after the last session. Dermatological examination revealed perifollicular atrophic depigmented macules on perineum and mons pubis. Figure 1a The shape, size, and location of the lesions correlated with the width of laser probe and treatment area. Patient was Fitzpatrick phototype IV. White clods on multiple white structureless areas and perifollicular hypopigmentation were observed on dermatoscopic examination. Figure 1b Histopathological examination of incisional biopsy specimens from mons pubis revealed acanthosis, hyperkeratosis, and loss of rete pegs in epidermis. In upper dermis there was hyalinized zone with increased connective tissue. Mononuclear cell infiltration dispread from upper dermis to middle dermis was observed. Figure 1c With these findings patient was diagnosed with LS. Borrelia burgdorferi antibodies were negative. Antinuclear antibody and nuclear antibody immunoblot tests were also negative. Treatment choice for this patient was tacrolimus monohydrate 0.1 ointment twice daily for 3 months and mometasone furoate cream usp 0.1 once daily for 1 month; 90% clinical response was achieved with this treatment.