The review scientific article lists the etiology, ecological factors, pathogenesis, clinical picture, diagnosis, treatment and prevention of Lyme borreliosis. Comment: Invited article in a prestigious journal.
F.21 Development of new health/diagnostic methods/procedures
COBISS.SI-ID: 4721580Based on their own findings and a review of the literature, the authors shed light on the importance of CXCL13 in the diagnosis of Lyme neuroborreliosis and anticipate the areas and research needed to deepen the understanding of the diagnostic significance of CXCL13. Comment: Editorial in a prestigious scientific journal.
F.21 Development of new health/diagnostic methods/procedures
COBISS.SI-ID: 19228931Statins have anti-inflammatory and potentially antimicrobial activity, but whether they have a beneficial effect on the course of infectious diseases is controversial. In this study, we assessed the impact of pre-existing statin use on the course and outcome of Lyme neuroborreliosis manifested as meningoradiculitis (Bannwarth’s syndrome). 123 consecutive patients with Bannwarth’s syndrome of whom 18 (14.6%) were being treated with statins, were included in the study. To assess the influence of statin use on the course and outcome of the disease, univariate and multivariable analyses were performed. No statistically significant association was found between statin pre-treatment and the clinical manifestations, laboratory test results, and outcome of Bannwarth’s syndrome. In conclusion, pre-existing use of statins did not significantly impact either the clinical presentation or the outcome of Bannwarth’s syndrome. Comment: Results relevant to everyday clinical practice with favorable economic effects.
F.21 Development of new health/diagnostic methods/procedures
COBISS.SI-ID: 29554435Background. Information on Lyme borreliosis in patients treated with rituximab is limited to individual case reports. Methods. We reviewed data on adult patients diagnosed with typical erythema migrans (EM) at the Lyme borreliosis Outpatient Clinic of the University Medical Center Ljubljana, Slovenia, in the 10-year period 2008–2017. For all patients, clinical and laboratory information was acquired prospectively using a standardized questionnaire. Results. Among 4,230 adult patients diagnosed with EM, 7 (0.17%) patients, comprising 5 women and 2 men with a median age of 65 (55–66) years, were receiving rituximab for an underlying medical condition. In these 7 patients, signs of disseminated Lyme borreliosis (43%) and the isolation rates of borreliae from blood before antibiotic treatment (40%) were unusually high in comparison with corresponding findings in immunocompetent patients diagnosed with EM at the same institution (8% and (2%, respectively). The presence of LB-associated constitutional symptoms and borrelial antibodies in serum were lower than expected (14% and 29% in patients receiving rituximab versus 25% and 65% in immunocompetent patients). One of the 7 (14%) patients experienced treatment failure; nevertheless, the outcome of early Lyme borreliosis 1 year after antibiotic treatment as used for immunocompetent patients with EM was excellent in all 7 patients. Conclusions. Findings in 7 patients with erythema migrans who were receiving rituximab for underlying disease suggest that although early Lyme borreliosis in these patients is more often disseminated than in immunocompetent patients, the outcome 1 year after antibiotic treatment as used for immunocompetent patients is excellent. Comment: Results relevant to everyday clinical practice with favorable economic effects.
F.21 Development of new health/diagnostic methods/procedures
COBISS.SI-ID: 6290604To assess whether differences in presentation between US and European patients with early Lyme borreliosis are due to the lower rate of spirochetemia in Europe, we compared multiple variables for patients with erythema migrans (EM), restricting the analysis to subjects with a positive blood culture at the time of presentation: 93 US patients infected with Borrelia burgdorferi versus 183 European patients infected with Borrelia afzelii (No = 144) or Borrelia garinii (No = 39). Compared to spirochetemic Slovenian EM patients infected with B. afzelii, US patients with a positive blood culture significantly less often recalled a preceding tick bite at the site of the EM skin lesion, had a shorter duration of EM prior to diagnosis and more often had multiple EM lesions, regional lymphadenopathy, constitutional symptoms, an increased ESR value, a low blood lymphocyte count and detectable borrelia antibodies in acute and convalescent phase blood samples. Similar differences were observed when US patients were compared to Slovenian patients with B. garinii infection, but not all reached statistical significance. The findings are comparable to those previously reported for the corresponding skin culture positive patients and do not support the hypothesis that a higher frequency of spirochetemia at the time of presentation in US patients with EM, compared with European EM patients, is the reason for the observed differences. Comment: Results relevant to everyday clinical practice.
F.21 Development of new health/diagnostic methods/procedures
COBISS.SI-ID: 59069699