Nadelman Robert B, Wormser Gary P
Division of Infectious Diseases, Department of Medicine, New York Medical College, Valhalla, NY 10595, USA.
Clin Infect Dis. 2007 Oct 15;45(8):1032-8. doi: 10.1086/521256. Epub 2007 Sep 11.
Lyme disease is the most common tick-borne infection in the United States and Europe. A surprising number of patients experience a subsequent episode of Lyme disease after the first episode has resolved. Reinfection has been well-documented only after successfully treated early infection (nearly always erythema migrans) and can often be recognized clinically by the development of a repeat episode of erythema migrans occurring at a different location on the skin during months when the principal tick vectors are abundant in the environment. Limited data suggest that the clinical and laboratory manifestations of reinfection in patients with Lyme disease with erythema migrans are not very different from those of initial infection. Patients with recurrent infections afford an opportunity to study the role of the immune response in this illness. Because patients with early Lyme disease continue to remain at high risk for reinfection, this population should be targeted for education about prevention of Lyme disease.
莱姆病是美国和欧洲最常见的蜱传感染疾病。在首次发作消退后，有相当数量的患者会经历莱姆病的后续发作。仅在早期感染（几乎总是游走性红斑）成功治疗后，再感染才有充分的文献记载，并且在主要蜱虫媒介在环境中大量存在的月份里，皮肤上不同部位出现游走性红斑的重复发作，临床上通常可以识别。有限的数据表明，患有游走性红斑的莱姆病患者再感染的临床和实验室表现与初次感染的表现没有太大差异。反复感染的患者为研究免疫反应在这种疾病中的作用提供了机会。由于早期莱姆病患者仍然面临较高的再感染风险，这一人群应作为莱姆病预防教育的目标对象。
