Remy V
Service de médecine interne et maladies infectieuses, centre hospitalier de Cahors, 335, rue du Président Wilson, 46000 Cahors, France.
Med Mal Infect. 2007 Jul-Aug;37(7-8):410-21. doi: 10.1016/j.medmal.2006.01.027. Epub 2007 Mar 13.
Lyme borreliosis (LB) is a multisystemic infection transmitted by ticks. Its diagnosis is based on clinical and biological criteria. These criteria could be different in Europe than in the USA, because of the existence of multiples strains of borrelia in Europe. In primary stage of LB, the diagnosis is often clinical. In the secondary stage, LB diagnosis is established with an Elisa serology confirmed by a Western blot. The interpretation criteria of these laboratory tests should follow European recommendations (EUCALB). LB with neurological involvement should be confirmed by screening for intrathecal synthesis of borrelia antibodies in CSF. LB with rheumatologic expression could be confirmed by screening for borrelia in joint fluid by PCR. There is no strong marker of activity of the disease. Follow-up for LB is difficult, because antibodies may persist for years and LB does not confer immunization.
莱姆病(LB)是一种由蜱传播的多系统感染性疾病。其诊断基于临床和生物学标准。由于欧洲存在多种伯氏疏螺旋体菌株,这些标准在欧洲和美国可能有所不同。在莱姆病的初级阶段,诊断通常基于临床症状。在第二阶段,通过酶联免疫吸附测定(ELISA)血清学检测并经蛋白质印迹法确认来确诊莱姆病。这些实验室检测的解读标准应遵循欧洲的建议(EUCALB)。伴有神经系统受累的莱姆病应通过检测脑脊液中伯氏疏螺旋体抗体的鞘内合成来确诊。具有风湿表现的莱姆病可通过聚合酶链反应(PCR)检测关节液中的伯氏疏螺旋体来确诊。目前尚无该疾病活动的强标志物。莱姆病的随访较为困难,因为抗体可能会持续数年,且莱姆病不会产生免疫。