Service de médecine nucléaire, hôpital de la Timone, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France; CERIMED, Aix-Marseille université, 13005 Marseille, France; CNRS, centrale Marseille, institut Fresnel, Aix-Marseille université, 13005 Marseille, France.
SSA, VITROME, IHU méditerranée infection, IRD, Aix-Marseille université, AP-HM, 13005 Marseille, France.
Med Mal Infect. 2019 Mar;49(2):150-156. doi: 10.1016/j.medmal.2019.01.002. Epub 2019 Feb 5.
Approximately 10% of patients presenting with Lyme disease experience fatigue, musculoskeletal pain, concentration disorders, or short-term memory deficits in the six months following treatment. This entity has been defined as post-Lyme disease syndrome or post-treatment Lyme disease syndrome. The pathophysiology of this syndrome is unknown, but neither persistence of the bacterium nor effectiveness of antibiotics are currently reported in the literature. The French High Council for Public Health (French acronym HCSP) has recently defined a new entity called "persistent polymorphic symptoms after a tick bite" allowing for designing studies to better understand these subjective presentations, for which objective biomarkers are currently lacking. This entity encompasses patients experiencing fatigue and generalized pain in the months following a tick bite and can be associated with several subjective symptoms with major impact on the quality of life. In the field of somatoform disorders, this article reviews functional neuroimaging studies in patients presenting with subjective complaints and discusses potential clinical implications for persisting symptoms after tick bites and post-treatment Lyme disease syndrome.
约 10%的莱姆病患者在治疗后 6 个月内会出现疲劳、肌肉骨骼疼痛、注意力障碍或短期记忆缺失。这种情况被定义为莱姆病后综合征或治疗后莱姆病综合征。该综合征的病理生理学尚不清楚，但目前文献中既没有报道细菌的持续存在，也没有报道抗生素的有效性。法国公共卫生高级理事会（法语缩写 HCSP）最近定义了一种新的实体，称为“蜱叮咬后的持续性多态性症状”，这使得设计研究以更好地理解这些主观表现成为可能，而目前这些表现缺乏客观的生物标志物。该实体包括在蜱叮咬后数月内出现疲劳和全身疼痛的患者，并且可能与几种对生活质量有重大影响的主观症状相关。在躯体形式障碍领域，本文综述了出现主观症状患者的功能神经影像学研究，并讨论了蜱叮咬后和治疗后莱姆病综合征持续症状的潜在临床意义。
