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Tick-borne borreliosis: symptoms, diagnosis, treatment and prevention

Lyme borreliosis (ixodic tick-borne borreliosis, Lyme disease) refers to a large group of infectious diseases (more than 200) of natural focal genesis transmitted through the bites of bloodsucking insects (transmission infection).

Because of the wide range of damage to the body, over 100 years, the disease was given various definitions - lymphocytic meningoradiculoneuritis, acrodermatitis, cutaneous lymphadenosis.

Only in the early 90-ies of the last century the disease was called "tick borreliosis", and at the end of the nineties (1997) it was registered as "Lime-borreliosis".

Content

Distribution and infection with tick borreliosis

the causative agent of the disease, photo 1

the causative agent of the disease, photo 1

The causative agent of the disease are spirotechi of the family "Borrelia burgdorferi sensu lato", which include about 10 genotypes of bacteria, which are characterized by intracellular development (persistence). Three of them cause various functional disorders in the human body:

  • "Borrelia burgdorferi sensu stricto" - development of locomotor disorders (Lym-arthritis);
  • "Borrelia garinii" - changes in the nervous structures;
  • "Borrelia afzelii" - skin pathologies.

The carriers of the causative agent are taiga and forest spider-like tick-borne parasites of the genus Ixodes. The reservoir and their feeder are small mammals, wild and domestic animals, a huge number of birds (more than a hundred species).

Many of them are carriers of the causative agent of tick-borne borreliosis and encephalitis virus, which causes mixed infection. Outbreaks are characterized by seasonality - spring-summer, or the first months of autumn, with a high activity of ticks.

The main way of infection with borreliosis is the tick bite (the transmissible pathway). Through the saliva of the tick, with its suction, through the contents of the intestine and excrement, when it is crushed or combed.

The usual latent period (incubation) is up to two weeks. But if the infection is in the spilled, generalized stage, the infection can occur immediately from the first day of the insect bite.

Saliva mite has an amazing property - vasodilator, anticoagulant and anesthetic. Therefore, the suction of the parasite is not noticed immediately.

Itching and painful symptoms appear after 5-10 hours. Iksodovye females can be saturated for a long time - up to a week or more.

In the presence of an agent only in its intestine, infection occurs in the second phase of its feeding (after a two-day suction). Therefore, early detection and removal can prevent infection.

There may be an alimentary transmission of infection - raw milk, or dairy products that have not undergone thermal treatment. And as a trans placental transmission pathway - from the mother to the fetus with the development of congenital pathologies or fetal death.

Symptoms of tick borreliosis in stages of development

The disease is characterized by a phased development.

First signs, photo

The first stage is characterized by local infection and the first signs of pathological changes developing at the site of infection.

The first signs of infection, photo 2

The first signs of infection, photo 2

The initial symptoms of tick-borne borreliosis appear 7-10 days after contact with the tick, manifested by annular erythematous formation at the site of suction.

After a while, the stain increases in size and its center becomes lighter. Possible swelling and cutaneous cyanosis in the affected area. Secondary areas of erythema appear with predominant localization on the earlobes and around the nipple.

The response of the body to the introduction of "stranger" into the body is manifested:

  • temperature increase;
  • fatigue and drowsiness;
  • articular aches;
  • muscle pain and stiffness;
  • signs of lymphadenopathy.

Almost 20 patients out of 100 have symptomatology without signs of erythema. It passes after a while (2-3 weeks), leaving a slight soreness and itching.

The second stage is characterized by the spread (dissemination) of the infection by migration with blood and lymph to various parts of the body.

Manifesting symptoms according to a certain localization.

The defeat of the CNS infection is characterized by signs of meningoencephalitis:

  1. symptoms of intoxication;
  2. photophobia and soreness of the eyes;
  3. hyperkinetic behavior disorder;
  4. hypnosis (memory deficiency) and reduced concentration of attention;
  5. development of muscle paresis on the face and neck.

With localized damage to the heart, the symptoms are:

  1. focal inflammatory processes of the heart muscle (myocarditis);
  2. inflammation of the connective tissue heart (pericarditis);
  3. the development of cardiac arrhythmia.

Infection of the liver causes a diffuse lesion of its tissues, and the influence of Ixodes on the joints leads to the formation of migrating polyarthralgias with pathological changes in the major joints (Lym-arthritis).

The penetration of Borrelia into the organ of vision is reflected:

  1. inflammation of the conjunctiva;
  2. inflammatory reactions of the uveal tract and the vascular ocular membrane itself;
  3. processes of inflammation in the iris and ciliary (ciliary) body of the eye;

Under the influence of Ixodes influence, angina, bronchitis and orchitis are activated. Kidney pathologies are expressed by microhematuria and proteinuria. All this is accompanied by exhaustion and increased fatigue (asthenic syndrome).

The third stage of the development of the disease is characterized by organ damage, due to the prolonged exposure of the pathogen to individual organs and systems. Within two years there is an active progression of the joint and skin pathologies, functional disorders in the structure of the central nervous system.

The provoking factor of chronic development of borreliosis is caused by:

  1. mild or late borrelemia, contributing to a delayed type of hypersensitivity (immune response);
  2. development of the paradoxical reaction of the organism to its own antigens;
  3. adaptation of the pathogen to intracellular development.

Failure of treatment or its complete absence leads to persistent chronic borreliosis, with stages of remission and exacerbation, or by constant relapses leading to:

  • to destructive changes in bone and cartilage structures;
  • development of osteoporosis;
  • formation of nodular infiltrates (lymphocytoma);
  • atrophy of skin areas due to acrodermatitis.

Chronic course of borreliosis can lead to irreversible consequences and to the status of a disabled person for the patient.

Complication of the SDS

Complications of tick-borne borreliosis The consequences of tick-borne borreliosis can be very serious, manifesting themselves as:

  • dementia (dementia);
  • the formation of paralysis or paresis of the facial nerves;
  • severe hearing impairment or complete deafness;
  • violation of visual functions;
  • tahisystolic signs;
  • arthritis and skin pathologies.

Inspection and diagnosis of tick borreliosis

An important criterion in the diagnosis of tick-borne borreliosis is: the identification of the source of infection and the ways of its spread, the peculiarity of clinical manifestations, the severity of the disease through the detection of laboratory findings.

Assessment of the patient's condition is due to a number of diagnostic measures.

  1. Identification of Ixodes in the marginal zone of erythema, in its tissues and synovia.
  2. Microscopic examination of spirotechi Borrelia.
  3. RNIF reactions for the presence of antibodies in the blood.
  4. Immunological (ELISA) and serological tests - for qualitative and quantitative detection of antibodies and determination of their titres (a long indicator of high titers indicates continuation of the infectious process)

Treatment of Lyme borreliosis

close-up, photo 4

close-up, photo 4

Successful treatment of tick borreliosis depends on the form of the disease and the stage of its development. The initial forms are well amenable to drug therapy. Medicinal doses are prescribed individually, according to the clinical picture. As etiotropic (causal) therapy.

  • A two-week course of taking "Doxycycline", "Tetracycline" and "Cefuroxime" is prescribed.
  • From the second to the fifth day - a single dose of "Azithromycin".
  • With the symptoms of meningitis - "Penicillin", "Ampicillin" and "Amkosksitsillin."
  • "Tsifriakson" or "Claforan" in the late stage of the disease.
  • The purpose of anti-malignant gamma globulin is effective with a mix of infection - tick-borne borreliosis and encephalitis virus.

For the correction of impaired functions, pathogenetic therapy is applied, which includes:

  • drugs NSAIDs - pain relievers, antipyretic, anti-inflammatory;
  • antiallergic and antihistamines;
  • vitamin and immunostimulating complexes;
  • physiotherapeutic procedures.

Prevention of SDS

Since there are no vaccines from the ICD, prevention is based on measures to prevent the tick from reaching open areas of the body:

  • cover your head with a headdress;
  • outerwear should be long-sleeved;
  • the bottom edge of the trousers is pulled off with ribbons or a rubber band;
  • shoes, if possible, high.

Going to a picnic, you should treat the clothes with a special protective equipment. If the mite is attached to the skin, it is not recommended to squeeze it and pull it out with sharp jerks.

It is necessary to cover his breath, putting on the surface of the back of any cream. After 10-15 minutes, carefully remove by twisting.

Treat the place of bite with iodine.

Measures of prophylaxis after a tick bite

Effective prophylaxis of tick-borne borreliosis after tick bite is the intake of antibiotics that prevent the development of the disease in almost 95%.

  1. "Doxycycline" - ten days (0.1g. 2 / day).
  2. "Extensillin" - once intramuscularly (2.4 million units)
  3. "Amoxiclav" - five days (0, 375 g. 4 / day).

Treatment should be done no later than five days after the alleged infection.

Tick-borne borreliosis in the ICD 10

In the international classification of diseases of the 10th revision, the disease is:

Class I. Some infectious and parasitic diseases (A00-B99)

A69 - Other infections caused by spirochetes

  • A69.2 Lyme disease (tick-borne borreliosis)
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