Assuntos
Borrelia/isolamento & purificação , Coinfecção/diagnóstico , Eritema Migrans Crônico/microbiologia , Eritema Migrans Crônico/virologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anaplasma phagocytophilum/genética , Anaplasma phagocytophilum/isolamento & purificação , Bancos de Espécimes Biológicos , Borrelia/genética , Ehrlichiose/sangue , Ehrlichiose/diagnóstico , Vírus da Encefalite Transmitidos por Carrapatos/genética , Vírus da Encefalite Transmitidos por Carrapatos/isolamento & purificação , Encefalite Transmitida por Carrapatos/sangue , Encefalite Transmitida por Carrapatos/diagnóstico , Feminino , Humanos , Doença de Lyme/sangue , Doença de Lyme/diagnóstico , Masculino , Pessoa de Meia-Idade , Rickettsiaceae/genética , Rickettsiaceae/isolamento & purificação , Infecções por Rickettsiaceae/sangue , Infecções por Rickettsiaceae/diagnóstico , Suécia , Adulto JovemRESUMO
Lyme borreliosis (LB), tick-borne encephalitis (TBE) and human granulocytic anaplasmosis (HGA) are endemic in central part of Slovenia. We tested the hypothesis that patients with erythema migrans (EM) from this region, who have leukopenia and/or thrombocytopenia (typical findings in HGA and in the initial phase of TBE but not in patients with LB) are coinfected with Anaplasma phagocytophilum and/or with TBE virus, i.e. that cytopenia is a result of concomitant HGA or the initial phase of TBE. Comparison of clinical and laboratory findings for 67 patients with EM who disclosed leukopenia/thrombocytopenia with the corresponding results in sex- and age-matched patients with EM and normal blood cell counts revealed no differences. In addition, patients with typical EM and leukopenia and/or thrombocytopenia tested negative for the presence of IgM and IgG antibodies to TBE virus by ELISA as well as for the presence of specific IgG antibodies to A. phagocytophilum antigens by IFA in acute and convalescent serum samples. Thus, none of 67 patients (95% CI: 0 to 5.3%) with typical EM (the presence of this skin lesion attests for early Lyme borreliosis and is the evidence for a recent tick bite) was found to be coinfected with A. phagocytophilum or had a recent primary infection with TBE virus. The findings in the present study indicate that in Slovenia, and probably in other European countries endemic for LB, TBE and HGA, patients with early LB are rarely coinfected with the other tick-transmitted agents.
Assuntos
Coinfecção/epidemiologia , Ehrlichiose/epidemiologia , Encefalite Transmitida por Carrapatos/epidemiologia , Eritema Migrans Crônico/epidemiologia , Leucopenia/epidemiologia , Doença de Lyme/epidemiologia , Trombocitopenia/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anaplasma phagocytophilum/isolamento & purificação , Ehrlichiose/complicações , Vírus da Encefalite Transmitidos por Carrapatos/isolamento & purificação , Encefalite Transmitida por Carrapatos/complicações , Eritema Migrans Crônico/complicações , Eritema Migrans Crônico/microbiologia , Eritema Migrans Crônico/virologia , Feminino , Humanos , Leucopenia/complicações , Doença de Lyme/complicações , Masculino , Pessoa de Meia-Idade , Eslovênia/epidemiologia , Trombocitopenia/complicações , Adulto JovemRESUMO
The aim of the study was the analysis of Lyme borreliosis cases notified by Clinic for Infections Diseases in Wroclaw in connection with exposure to ticks in year 2002. In the analyzed group of patients tick bites were confirmed in 77.9% and the most common places of exposition were forest regions in Lower Silesia (Masyw Slezy, Wzgórza Twardógorskie, Kotlina Klodzka, Wzgórza Trzebnickie, Bory Dolnoslaskie) and in Wroclaw area. EM appeared in 55.8% cases. In cases of multiple ticks professionally exposured persons EM appeared only in 22.2%.