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[莱姆病与回归热]

[Borreliosis and relapsing fever].

作者信息

Raffetin Alice, Patrat-Delon Solène, Cazorla Céline, Tattevin Pierre, Eldin Carole

机构信息

Centre de Référence des maladies vectorielles à tiques (CRMVT), Paris et région Nord, CH Villeneuve-Saint- Georges, France.

CRMVT, Région Grand-Ouest, CHU Rennes Pontchaillou, Rennes, France.

出版信息

Rev Prat. 2021 Dec;71(10):1113-1117.

PMID:35147372
Abstract

BORRELIOSIS AND RELAPSING feverrelapsing fevers borreliosis (RFB) are caused by bacteria of the genus Borrelia, within the spirochete's family, transmitted to Humans by arthropods (lice Pediculus humanus, soft ticks of the genus Ornithodoros, or hard ticks for one of them). The RFB transmitted by body lice is cosmopolitan and occurs during epidemics in the context of major crises (promiscuity, precarious hygiene conditions, food crises, etc.). RFB transmitted by ticks are distributed by region, according to the Borrelia species and the geographical repartition of the tick involved (sporadic transmission). The incubation period varies from 3 to 20 days. The first febrile phase lasts 3 days (1-14 days), followed by a phase of apyrexia with persistence of other clinical signs (skin rash, petechiae, headaches, agitation, polyarthromyalgia, abdominal pain, nausea/vomiting, etc.). The recurrence of fever occurs every 7 days on average. Bacteremia in the blood is abundant during fever allowing direct diagnosis by microscopy, Borrelia PCR or culture on a specific medium when available. The first-line treatment is doxycycline, except in case of neurological involvement (ceftriaxone). The mortality Rate varies from 2 to 5 % depending on the Borrelia Species involved. The outcome is usually good after treatment.

摘要

莱姆病和回归热回归热螺旋体病(RFB)由螺旋体科疏螺旋体属细菌引起,通过节肢动物(人体虱、钝缘蜱属软蜱或其中一种硬蜱)传播给人类。由体虱传播的RFB在全球范围内存在,在重大危机(混乱、卫生条件差、粮食危机等)背景下的流行期间发生。由蜱传播的RFB根据疏螺旋体种类和相关蜱的地理分布按区域分布(散发传播)。潜伏期为3至20天。首个发热期持续3天(1至14天),随后是无热期,伴有其他临床症状(皮疹、瘀点、头痛、烦躁、多关节痛、腹痛、恶心/呕吐等)持续存在。发热平均每7天复发一次。发热期间血液中的菌血症丰富,可通过显微镜检查、疏螺旋体PCR或在有可用的特定培养基上培养进行直接诊断。一线治疗是多西环素,神经系统受累情况除外(头孢曲松)。死亡率因所涉及的疏螺旋体种类而异,为2%至5%。治疗后通常预后良好。

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