Bonoldi Virginia Lucia Nazario, Yoshinari Natalino Hajime, Trevisan Giusto, Bonin Serena
Reumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05508-220, Brazil.
Department of Medical Sciences, University of Trieste, 34149 Trieste, Italy.
Microorganisms. 2024 Oct 21;12(10):2108. doi: 10.3390/microorganisms12102108.
Compared to classic Lyme disease (LD), Baggio-Yoshinari syndrome (BYS) has the following distinctive characteristics: it is transmitted in the Amazon area and Northeast, Central-West, Southeast, and South regions of Brazil by hard ticks, notably or sp. The absence of sp. ticks in areas at risk of BYS in Brazil is probably the main reason for the disease's differences from LD in the United States, Europe, and Asia. Biodiversity and climate probably favor the formation of atypical pleomorphic Borrelias, which have not yet been cultivated or isolated. Clinically, the first manifestation of BYS is the erythema migrans as in the classic forms of Lyme disease, but BYS is distinguished from LD by its prolonged clinical evolution, with a high frequency of relapses and the appearance of autoimmune manifestations. Prevalent symptoms are headache and erythema nodosum. Five clinical cases of BYS in patients who contracted the disease in the Brazilian Amazon rainforest are described here. This syndrome should be considered among differential diagnoses in patients bitten by ticks in Brazil who present with erythema migrans and/or headache. It is important to pursue an early diagnosis because symptoms respond well to antibiotics in the early stages; if treatment is started late, a chronic course with articular and neurological sequelae can be detected.
与经典莱姆病（LD）相比，巴乔 - 吉纳里综合征（BYS）具有以下显著特征：它在巴西的亚马逊地区以及东北部、中西部、东南部和南部地区由硬蜱传播，特别是 或 种。巴西BYS风险地区缺乏 种蜱可能是该疾病与美国、欧洲和亚洲的莱姆病存在差异的主要原因。生物多样性和气候可能有利于非典型多形性疏螺旋体的形成，这些疏螺旋体尚未被培养或分离出来。临床上，BYS的首发表现与经典莱姆病形式一样是游走性红斑，但BYS与LD的区别在于其临床病程延长，复发频率高且出现自身免疫表现。常见症状是头痛和结节性红斑。本文描述了5例在巴西亚马逊雨林感染该病的BYS临床病例。对于在巴西被蜱叮咬后出现游走性红斑和/或头痛的患者，在鉴别诊断时应考虑这种综合征。早期诊断很重要，因为症状在早期对抗生素反应良好；如果治疗开始较晚，可能会出现伴有关节和神经后遗症的慢性病程。
