Yoshinari N H, Oyafuso L K, Monteiro F G, de Barros P J, da Cruz F C, Ferreira L G, Bonasser F, Baggio D, Cossermelli W
Disciplina de Reumatologia, Faculdade de Medicina, Universidade de São Paulo.
Rev Hosp Clin Fac Med Sao Paulo. 1993 Jul-Aug;48(4):170-4.
Lyme disease is an infectious disease caused by spirochete Borrelia burgdorferi transmitted by Ixodid tick bite. The geographic distribution of the disease is universal, but the disease has not been identified definitely in South America yet. We report a probable case of Lyme disease in a woman, living in Jagůaré slum (São Paulo), who showed characteristics skin lesions of erythema chronicum migrans, with fever, weakness, headache, muscular pain, cough, arthralgia and sensitive radicular neuropathy in the left arm. The sequential serology made by ELISA method, using Borrelia burgdorferi whole sonicated antigen from Dr. Allen C. Steere laboratory, showed high titers of IgM antibody (1:1600). Because of the persistence of high IgM response for two months, we decided to treat the patient with tetracycline 2g/day during 10 days and the sorology became negative two months. The western blotting confirmed ELISA results showing presence of five bands (IgM). This report fulfills CDC criteria for Lyme disease diagnosis.
莱姆病是一种由伯氏疏螺旋体引起的传染病,通过硬蜱叮咬传播。该病的地理分布广泛,但南美洲尚未明确发现过该疾病。我们报告了一例可能的莱姆病病例,患者为一名居住在雅瓜雷贫民窟(圣保罗)的女性,表现出慢性游走性红斑的特征性皮肤病变,并伴有发热、乏力、头痛、肌肉疼痛、咳嗽、关节痛以及左臂感觉神经根神经病。采用来自艾伦·C·斯梯尔博士实验室的伯氏疏螺旋体全超声破碎抗原,通过酶联免疫吸附测定(ELISA)方法进行的系列血清学检测显示,IgM抗体滴度很高(1:1600)。由于高IgM反应持续了两个月,我们决定让患者每天服用2克四环素,持续10天,两个月后血清学检测结果转为阴性。蛋白质印迹法证实了ELISA结果,显示存在五条带(IgM)。本报告符合美国疾病控制与预防中心(CDC)莱姆病诊断标准。