Beginning >> Diseases >> Infectious >> Neuroborreliosis

Neuroborreliosis

Neuroborreliosis (laymsky illness) — the infectious multisystem disease caused by a spirochete of Borrelia burgdorferi and transmitted to the person at a sting of a tick. In the territory of our country cases are registered in zones of dwelling of ixodic mites: in the northwest and central regions of the European part, in Cisural area, Western Siberia and in the Far East, i.e. in regions, endemic and on a tick-borne encephalitis. Infection most often occurs late spring, in the flying and in the early fall when activity of mites is especially high.

Clinical picture.

Allocate three stages of a disease. The first stage develops within several days or weeks after a sting of a tick and is characterized by emergence in the place of a sting of the ring-shaped erythema which is gradually increasing in sizes which quite often is followed by a headache, fever, a pharyngalgia or a stomach, muscular and joint pains.
The second stage develops in 1 — 2 month and is shown by neurologic disturbances (acute serous meningitis, defeat of a facial nerve, a meningoradiculitis), pathology of heart (carditis) and joints (palindromic rheumatism). The meningoradiculitis is characterized by defeat of roots of spinal nerves and inflammatory changes in cerebrospinal liquid. He debuts a megalgia which can be localized near the place of a sting or in spin and irradiate in a zone of an innervation of roots. In several days or weeks asymmetric paresis in upper or lower extremities joins, sensitivity is broken, tendon jerks drop out. At this stage emergence of symptoms of acute or subacute encephalitis or a myelitis is possible.
The third stage arises several months or flying later and is shown by the progressing encephalomyelitis with development of paresis, an ataxy, mental disturbances, epileptic seizures, a polyneuropathy and chronic arthritis.
The diagnosis is made on the basis of the instruction in the anamnesis on a sting of a tick, existence of a ring erythema, a palindromic rheumatism. It is also necessary to consider endemicity of the region and a season of year. The diagnosis is confirmed by the serological methods revealing antibodies to the activator in serum or cerebrospinal liquid.

Treatment.

 In the first stage of an illness appoint antibiotics (doxycycline, ampicillin or erythromycin) inside during 2 — 3 weeks. In the second stage parenterally enter high doses of penicillin (to 24 000 000 PIECES a day) and cephalosporins of the third generation; course 2 duration — 3 weeks (the II stage) or 3 — 4 weeks (the III stage). The earlier treatment, the higher it efficiency is begun. At a severe defeat of TsNS forming of the resistant residual phenomena (paresis, an ataxy, epileptic seizures, decrease in intelligence, etc.) is possible.

 
"Mukoroz   Nocardiosis"