Hengge Ulrich R, Tannapfel Andrea, Tyring Steven K, Erbel Raimund, Arendt Gabriele, Ruzicka Thomas
Department of Dermatology, Düsseldorf, Germany.
Lancet Infect Dis. 2003 Aug;3(8):489-500. doi: 10.1016/s1473-3099(03)00722-9.
Lyme borreliosis is a multi-organ infection caused by spirochetes of the Borrelia burgdorferi sensu lato group with its species B burgdorferi sensu stricto, Borrelia garinii, and Borrelia afzelii, which are transmitted by ticks of the species Ixodes. Laboratory testing of Lyme borreliosis includes culture, antibody detection using ELISA with whole extracts or recombinant chimeric borrelia proteins, immunoblot, and PCR with different levels of sensitivity and specificity for each test. Common skin manifestations of Lyme borreliosis include erythema migrans, lymphocytoma, and acrodermatitis chronica atrophicans. The last two conditions are usually caused by B garinii and B afzelii, respectively, which are seen more frequently in Europe than in America. Late extracutaneous manifestations of Lyme borreliosis are characterised by carditis, neuroborreliosis, and arthritis. We present evidence-based treatment recommendations for Lyme borreliosis and review the prevention of Lyme borreliosis, including the Lyme vaccines.
莱姆病是一种由伯氏疏螺旋体狭义组的螺旋体引起的多器官感染，其种类包括狭义伯氏疏螺旋体、伽氏疏螺旋体和阿氏疏螺旋体，通过硬蜱属的蜱传播。莱姆病的实验室检测包括培养、使用全提取物或重组嵌合伯氏螺旋体蛋白的酶联免疫吸附测定（ELISA）进行抗体检测、免疫印迹以及聚合酶链反应（PCR），每种检测的敏感性和特异性水平各不相同。莱姆病常见的皮肤表现包括游走性红斑、淋巴细胞瘤和慢性萎缩性肢端皮炎。后两种情况通常分别由伽氏疏螺旋体和阿氏疏螺旋体引起，在欧洲比在美国更常见。莱姆病的晚期皮肤外表现以心脏炎、神经莱姆病和关节炎为特征。我们提出了基于证据的莱姆病治疗建议，并综述了莱姆病的预防措施，包括莱姆病疫苗。
