Dersch Rick, Fingerle Volker
Klinik für Neurologie und Neurophysiologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert- Ludwigs-Universität Freiburg.
Nationales Referenzzentrum für Borrelien, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Oberschleißheim.
Dtsch Med Wochenschr. 2021 Jun;146(11):728-732. doi: 10.1055/a-1265-4397. Epub 2021 Jun 1.
Lyme borreliosis is a tick-borne infectious disease caused by the spirochete bacterium Borrelia burgdorferi sensu lato. Lyme borreliosis is the most frequent zoonosis in Germany.Most cases show dermatological manifestations, like erythema migrans, followed by infections of the nervous system. Cerebrospinal fluid analysis should be performed if Lyme neuroborreliosis is suspected. Cell-based assays (like LTT or ELISPOT) should not be used when investigating Lyme disease.A recent randomized controlled trial showed a similar effect of doxycycline compared to betalactam-antibiotics regarding neurological symptoms in Lyme neuroborreliosis. This corroborates current German guideline recommendations.The prognosis of Lyme disease after antibiotic treatment is usually favorable. Frequency of fatigue, depression, impairments in quality of life and cognitive impairment are similar in patients after treatment of Lyme neuroborreliosis when compared to the general population.
莱姆病是一种由疏螺旋体伯氏疏螺旋体狭义亚种引起的蜱传感染性疾病。莱姆病是德国最常见的人畜共患病。大多数病例表现为皮肤症状，如游走性红斑，其次是神经系统感染。如果怀疑患有莱姆神经疏螺旋体病，应进行脑脊液分析。在研究莱姆病时不应使用基于细胞的检测方法（如淋巴细胞转化试验或酶联免疫斑点试验）。最近一项随机对照试验表明，在莱姆神经疏螺旋体病的神经症状方面，多西环素与β-内酰胺类抗生素的效果相似。这证实了当前德国指南的建议。抗生素治疗后莱姆病的预后通常良好。与普通人群相比，莱姆神经疏螺旋体病患者治疗后疲劳、抑郁、生活质量受损和认知障碍的发生率相似。
