Weber K, Neubert U, Thurmayr R
Zentralbl Bakteriol Mikrobiol Hyg A. 1987 Feb;263(3):377-88. doi: 10.1016/s0176-6724(87)80096-2.
Between December 1978 and July 1985, we used various antibiotics for the treatment of 97 adult patients with early erythema migrans disease (EMD). Six patients with borrelial lymphocytoma (BL) and 20 with acrodermatitis chronica atrophicans (ACA) were treated similarly. Follow-up was for a median of 20, 14, and 12 months, respectively. The erythema migrans and all associated symptoms resolved within a median of 3 weeks (0.5-18.4), BL within 7 weeks (4-16), and ACA partly or completely within several months. A Jarisch-Herxheimer (-like) reaction was observed in 8 patients with EMD. Fourteen patients with EMD and one with ACA developed an exacerbation of symptoms or new manifestations between the 2nd and 20th day, and 28 patients with EMD and one with ACA continued to have or acquired various symptoms greater than or equal to 3 weeks after initiation of therapy. Arthralgia, neurologic and constitutional symptoms, and in one instance a slight pulmonary interstitial edema developed in EMD. More severe initial illness was a risk factor for the development of later symptoms in EMD. Retreatment was more often necessary in ACA than in EMD. A patient with ACA had a recurrence after 5 1/2 years. IgG antibody titers rose at least fourfold in 5 patients with ACA and in 1 with EMD despite therapy. We tentatively recommend minocycline or high doses of parenteral penicillin for the treatment of these disorders.
1978年12月至1985年7月期间，我们使用了多种抗生素治疗97例成年早期游走性红斑病（EMD）患者。对6例莱姆淋巴细胞瘤（BL）患者和20例慢性萎缩性肢端皮炎（ACA）患者进行了类似治疗。随访时间中位数分别为20个月、14个月和12个月。游走性红斑及所有相关症状在中位数3周（0.5 - 18.4周）内消退，BL在7周（4 - 16周）内消退，ACA在数月内部分或完全消退。8例EMD患者出现了雅-赫（样）反应。14例EMD患者和1例ACA患者在第2天至第20天之间症状加重或出现新的表现，28例EMD患者和1例ACA患者在开始治疗后3周及以上持续有或出现各种症状。EMD患者出现关节痛、神经和全身症状，有1例出现轻度肺间质水肿。初始病情较重是EMD后期出现症状的一个危险因素。ACA患者比EMD患者更常需要再次治疗。1例ACA患者在5年半后复发。尽管进行了治疗，5例ACA患者和1例EMD患者的IgG抗体滴度至少升高了四倍。我们初步推荐米诺环素或大剂量胃肠外青霉素治疗这些疾病。
