De Wilde Maarten, Speeckaert Marijn, Callens Rutger, Van Biesen Wim
a Department of Nephroloy , Ghent University Hospital , Gent , Belgium.
Acta Clin Belg. 2017 Apr;72(2):133-137. doi: 10.1080/17843286.2016.1180829. Epub 2016 May 12.
'Chronic Lyme disease' is a controversial condition. As any hard evidence is lacking that unresolved systemic symptoms, following an appropriately diagnosed and treated Lyme disease, are related to a chronic infection with the tick-borne spirochaetes of the Borrelia genus, the term 'chronic Lyme disease' should be avoided and replaced by the term 'post-treatment Lyme disease syndrome.' The improper prescription of prolonged antibiotic treatments for these patients can have an impact on the community antimicrobial resistance and on the consumption of health care resources. Moreover, these treatments can be accompanied by severe complications. In this case report, we describe a life-threatening ceftriaxone-induced immune hemolytic anemia with an acute kidney injury (RIFLE-stadium F) due to a pigment-induced nephropathy in a 76-year-old woman, who was diagnosed with a so-called 'chronic Lyme disease.'
“慢性莱姆病”是一种存在争议的病症。由于缺乏确凿证据表明,在经适当诊断和治疗的莱姆病后仍未解决的全身症状与由蜱传播的疏螺旋体属螺旋体的慢性感染有关,因此应避免使用“慢性莱姆病”这一术语,而用“莱姆病治疗后综合征”来替代。对这些患者不恰当地开具长期抗生素治疗处方,可能会影响社区的抗菌药物耐药性以及医疗资源的消耗。此外,这些治疗可能会伴有严重并发症。在本病例报告中,我们描述了一名76岁女性因色素性肾病导致急性肾损伤(RIFLE分级F级),出现了危及生命的头孢曲松诱导的免疫性溶血性贫血,该患者被诊断患有所谓的“慢性莱姆病”。