Lyme borreliosis

被引:559
作者
Steere, Allen C. [1 ,2 ]
Strle, Franc [3 ]
Wormser, Gary P. [4 ]
Hu, Linden T. [5 ]
Branda, John A. [6 ]
Hovius, JoppeW. R. [7 ]
Li, Xin [8 ]
Mead, Paul S. [9 ]
机构
[1] Massachusetts Gen Hosp, Div Rheumatol Allergy & Immunol, Ctr Immunol & Inflammatory Dis, 55 Fruit St, Boston, MA 02114 USA
[2] Harvard Univ, Harvard Med Sch, Boston, MA 02115 USA
[3] Univ Med Ctr Ljubljana, Dept Infect Dis, Ljubljana, Slovenia
[4] New York Med Coll, Div Infect Dis, Valhalla, NY 10595 USA
[5] Tufts Med Ctr, Dept Mol Biol & Microbiol, Boston, MA USA
[6] Massachusetts Gen Hosp, Dept Pathol, Boston, MA 02114 USA
[7] Univ Amsterdam, Ctr Expt & Mol Med, Amsterdam, Netherlands
[8] Tufts Med Ctr, Div Geog Med & Infect Dis, Boston, MA USA
[9] Ctr Dis Control & Prevent, Bacterial Dis Branch, Div Vector Borne Dis, Ft Collins, CO USA
基金
美国国家卫生研究院;
关键词
BURGDORFERI SENSU-LATO; ACRODERMATITIS CHRONICA ATROPHICANS; TOLL-LIKE RECEPTOR-2; B-CELL RESPONSES; ERYTHEMA MIGRANS; PREVENT LYME; CEREBROSPINAL-FLUID; DISEASE SPIROCHETE; INTERPRETATION CRITERIA; INFLAMMATORY RESPONSES;
D O I
10.1038/nrdp.2016.90
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Lyme borreliosis is a tick-bornedisease that predominantly occurs in temperate regions of the northern hemisphere and is primarily caused by the bacterium Borrelia burgdorferi in North America and Borrelia afzelii or Borrelia garinii in Europe and Asia. Infection usually begins with an expanding skin lesion, known as erythema migrans (referred to as stage 1), which, if untreated, can be followed by early disseminated infection, particularly neurological abnormalities (stage 2), and by late infection, especially arthritis in North America or acrodermatitis chronica atrophicans in Europe (stage 3). However, the disease can present with any of these manifestations. During infection, the bacteria migrate through the host tissues, adhere to certain cells and can evade immune clearance. Yet, these organisms are eventually killed by both innate and adaptive immune responses and most inflammatory manifestations of the infection resolve. Except for patients with erythema migrans, Lyme borreliosis is diagnosed based on a characteristic clinical constellation of signs and symptoms with serological confirmation of infection. All manifestations of the infection can usually be treated with appropriate antibiotic regimens, but the disease can be followed by post-infectious sequelae in some patients. Prevention of Lyme borreliosis primarily involves the avoidance of tick bites by personal protective measures.
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页数:18
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