Eiffert H, Hanefeld F, Thomssen R, Christen H J
Dept. of Medical Microbiology, University Hospital, Göttingen, Germany.
Infection. 1996 Nov-Dec;24(6):437-9. doi: 10.1007/BF01713045.
Two patients with reinfection of Borrelia burgdorferi are presented. An 11-year-old girl developed recurrent acute peripheral facial palsy at an interval of five years. A 64-year-old woman showed paraesthesia in the leg and effusion in the knee. Three years later, an erythema migrans developed at the thigh. In both patients tick bites, corresponding clinical manifestations, and detection of specific antibodies proved the reinfections. The course of the humoral immune responses showed basic differences between the patients. At the interval between the first and second infection, the specific antibodies of the girl decreased beyond the cut-off level. On the other hand, the titer of specific IgG antibodies of the other patient remained at a constant level. Reasons for the failure of immune protection are discussed.
本文介绍了两例莱姆病螺旋体再感染患者。一名11岁女孩每隔五年出现复发性急性周围性面神经麻痹。一名64岁女性表现为腿部感觉异常和膝关节积液。三年后，大腿出现游走性红斑。在两名患者中，蜱叮咬、相应的临床表现以及特异性抗体检测均证实了再感染。体液免疫反应过程显示出患者之间的基本差异。在第一次和第二次感染的间隔期，女孩的特异性抗体降至临界值以下。另一方面，另一名患者的特异性IgG抗体滴度保持在恒定水平。文中讨论了免疫保护失败的原因。
