Tick-borne borreliosis - how to avoid serious consequences. Borreliosis - symptoms, consequences, treatment

Baraliosis is considered an infectious disease caused by spirochetes. The causative agents of the disease are wild animals and rodents. After biting an animal with baraliosis, the tick becomes infected and becomes a carrier of infection. The oral cavity of the insect is less infected with borreliosis than the body. The insect intestine contains the maximum number of microbes.

A person becomes infected with an infectious disease if they scratch the bite and damage the integrity of the tick’s body.

Symptoms of baraliosis

The incubation period from the moment of the bite to the appearance of the first symptoms of the disease is about two weeks. The early and late periods of borreliosis are classified:

1. Stage I. During the early period of its occurrence, a small redness forms at the site of the bite, the skin around it swells, over time, the redness and swelling reach large sizes, and a bluish appearance appears on the skin. In the center of the circle (erythema), a light spot is visualized, which expands over time and the swelling takes on a round shape; it can remain on the body for 1-2 months. The process of erythema formation is accompanied by high body temperature up to 39 °C, body aches, nausea, vomiting, headache, and joint pain. Sometimes symptoms of acute respiratory infections appear: sore throat, runny nose, cough. In addition to erythema, conjunctivitis, rashes on the face and urticaria may appear. During this period, damage to the soft membranes of the brain occurs with symptoms of meningitis.
2. Stage II of borreliosis is characterized by disruption of the nervous and cardiovascular systems. Shortness of breath and pressing pain in the heart area appear. The symptoms of meningitis become pronounced, disturbances in the emotional state and sleep occur, paralysis of the facial nerve occurs, and symptoms of arthritis appear. A rash appears on the palms of the hands.
3. Lyme disease in the late period (from six months to 2 years after the tick bite), stage III, is characterized by more severe symptoms. During this period, a person develops and progresses arthritis, cardiovascular diseases, arrhythmia, systematic skin rashes, malfunctions of the liver and nervous system disorders occur, the person feels weakness and malaise. Symptoms become chronic. At stage III, Borrelia microorganisms accumulate in large quantities in the brain, liver, heart and lungs of a person, disruption of the blood arteries occurs and, as a result, lead to death.

In some cases of borreliosis, the symptoms are episodic and it is very difficult for a person to determine what exactly is bothering him if he does not go to the hospital immediately after a tick bite.

This complicates the recovery process, in which case there is a high probability of an incorrect diagnosis and incorrect treatment.

Diagnosis of the disease

If a tick bite is noticed by a person immediately, it is necessary to go to the hospital as quickly as possible, because borreliosis is a very dangerous disease that is fatal if diagnosed late. When going to the hospital after a tick bite, first of all, the tick is removed from the skin using special devices: tongs, clamps, wire cutters. After this, the bite site is disinfected. Tests are prescribed: complete blood count, enzyme immunoassay, PCR, which can be used to detect the presence of Borrelia protein in the blood and tissues of the body.

These methods are used both for early diagnosis of a patient (immediately after a tick bite) and in the later stages of treatment. Diagnosis is mandatory in order to correctly determine the extent of the disease and select effective drugs for treatment.

Treatment after a barial tick bite

After diagnosing and examining the patient after a tick bite, treatment methods are determined and medications are selected. As a rule, treatment is carried out with the help of antibacterial, anti-inflammatory, immunostimulating drugs:

1. "Tetracycline". The drug is prescribed in combination with antibiotics for the treatment of early stages of baraliosis, 1.5 g per day. The duration of treatment is 1-2 weeks, depending on the symptoms of the disease and the severity of skin rashes.
2. "Vibramycin" is prescribed 0.1 g, 2 times a day, for 10 days.
3. “Doxycillin” is taken 2 capsules 2 times a day for complex disease progression in order to quickly relieve symptoms of erythema, and 1 capsule when the condition improves. The duration of treatment depends on the severity of the disease.
4. Penicillin is taken 3 times a day, 1 tablet. It has anti-inflammatory properties, destroys borelia, and alleviates the symptoms of the disease.
5. "Cefuroxime" kills pathogenic bacteria and cleanses the blood after a tick bite. Prescribe 2 tablets per day, lasting 20 days.
6. “Erythromycin” for Lyme disease is taken 1 tablet 4 times a day. Duration of treatment is 10-14 days.
7. "Ceftriaxone" 2-3 tablets per day, the duration of administration is determined by the doctor.
8. "Rifampin" is prescribed on the first day after a tick bite, 1 tablet per day, then depending on body weight. The duration of taking the drug is determined by the doctor.

Along with antibacterial and anti-inflammatory drugs that purify the blood and destroy microbes, the patient must be prescribed drugs to treat concomitant diseases that appeared after the bite of the barial tick. These are drugs to normalize the emotional background: antidepressants, sleeping pills. Drugs for the treatment of cardiovascular diseases, to support liver function and cleanse the blood and skin. Preparations for strengthening and normalizing the functions of the musculoskeletal system.

Drugs for the treatment of neurological diseases. It is necessary to say about the role of vitamins in the treatment of borreliosis, which affect the process of restoring the functioning of organs and systems and improve the patient’s condition. To treat bariasis after a tick bite, it is best to take multivitamins and vitamin complexes. This will help restore the functioning of organs and systems, have an immunostimulating effect on the human body and help ease the rehabilitation period for the patient after a tick bite. Only with an integrated approach to the treatment of borreliosis can one hope for a complete recovery of the patient.

When does the risk of borreliosis occur?

The spring period is characterized by the awakening of living organisms in nature; it is during this period that the maximum number of cases of barial tick bites occurs. The summer period also has high rates of the disease. Cases are more common in rural areas and private areas than in the city. This is due to the fact that in private areas and in rural areas there is more landscaping and vegetation, pets and livestock live on which ticks live and breed. Borreliosis infection is very difficult for the human body and never goes away without a trace; it has a particularly negative effect on the body of a pregnant woman and threatens the life of the unborn child. A woman may not suspect the presence of the disease, because sometimes there are no symptoms, so pregnant women need to be tested to detect borreliosis infection in the blood.

The consequences that occur in the human body after an illness provoke stages 2 and 3, while stage 1 passes without visible symptoms and appropriate treatment. Symptoms become chronic, disrupt the functioning of the body, reduce the level of performance and shorten life expectancy. The disease borreliosis is quite new; medicine is currently studying it. A vaccine has not yet been invented that would 100% destroy borreliosis infection. It is called Lyme disease because the first clinical case of the disease was recorded in the city of Lyme (Connecticut, USA), and was described by scientists from the same city.

In order to protect yourself from a tick bite and to prevent the disease, you must take precautions. Prevention of borreliosis includes the following rules:

1. For a trip to nature, you must wear light-colored clothes with long sleeves and closed shoes. This will make it easier to detect an insect on you, and long sleeves will prevent a tick bite.
2. It is necessary to use a repellent cream or spray that can be used not only on the body, but also on clothing to repel insects, including ticks.
3. You should not locate a place to rest in tall grass or under trees; it is better to use an open area for this.
4. If a tick bite does occur, it is necessary to carefully pull it out of the skin without damaging the body and in no case leaving the tick's head under the skin. It is better to use tweezers for this.
5. After removing the tick, the wound must be disinfected with an alcohol-containing solution.
6. If the tick or part of it remains under the skin and symptoms of borreliosis infection develop, you should definitely consult a doctor.
7. If the tick was successfully removed, but redness of the skin at the site of the bite, discomfort, and erythema appeared, this means that the tick was infected, you should go to the hospital.

It’s hard to imagine that a person can suffer a number of serious illnesses due to an infection that entered his body from a tick, and not know about it. The disease is insidious because it can “sit” in the human body for several years without manifesting itself. That is why doctors around the world are calling for timely treatment of a tick bite victim to the hospital. Timely examination of the patient will prevent the development of serious consequences of the disease.

Tick-borne borreliosis (Lyme disease, Lyme borreliosis) is an infectious disease transmitted through the bite of an ixodid tick. Characterized by damage to various organs and systems: skin, nervous system, heart, joints

Tick-borne borreliosis (Lyme disease, Lyme borreliosis) is an infectious disease transmitted through the bite of an ixodid tick. It is characterized by damage to various organs and systems: skin, nervous system, heart, joints.

With early detection and proper treatment with antibiotics, most cases result in recovery. Diagnosis of the disease at a late stage and inadequate therapy can contribute to the transition of the disease to a chronic, intractable form.

About the symptoms, diagnosis, treatment and consequences of tick-borne borreliosis

The name of the disease comes from the causative agent - a microorganism called Borrelia, carried by ticks. The second name “Lyme disease” appeared in 1975, when cases of the disease were reported in the small town of Lyme in the United States.

Causes

It has been established that the cause of tick-borne borreliosis is 3 types of Borrelia- Borrelia burgdorferi, Borrelia garinii, Borrelia afzelii. These are very small microorganisms (length 11-25 microns) in the shape of a convoluted spiral.

Under natural conditions, the natural reservoir of Borrelia is animals.: rodents, deer, cows, goats, horses, etc. The carrier is ixodid ticks, which become infected by sucking the blood of infected animals. Ticks are capable of transmitting Borrelia to their subsequent generations.

Ixodid ticks live mainly in zones with temperate climates, especially in mixed forests. Endemic zones of tick-borne borreliosis are the northwestern and central regions of Russia, the Urals, Western Siberia, the Far East, the USA, and some areas of Europe. During studies of ticks in endemic areas, it was found that tick infestation is up to 60%.

The peak incidence occurs in late spring - early summer, which is associated with an increase in tick activity during this period. A person has a high susceptibility to Borrelia, which means a high risk of the disease “when encountered.”

How does the disease develop?

Infection occurs through a tick bite. The pathogen penetrates the skin with saliva and multiplies there. Then it enters nearby lymph nodes, where it continues to multiply.

After a few days, borrelia penetrate the bloodstream and spread throughout the body through the bloodstream. This is how they enter the central nervous system, heart, joints, muscles, where they can remain for a long time, continuing to multiply.

The immune system produces antibodies against Borrelia, but even their high titers are not able to completely destroy the pathogen. Immune complexes that form as a result of tick-borne borreliosis can trigger the development of an autoimmune process (and then the production of antibodies is produced against the body’s own tissues). This fact can cause the chronic course of the disease. The death of the pathogen is accompanied by the release of toxic substances, which worsens the patient’s condition.

A sick person is not contagious to others and cannot become a source of infection.

Symptoms of tick-borne borreliosis

The disease occurs in several stages:

incubation period(the period from the moment of infection to the appearance of the first symptoms) – lasts from 3 to 32 days;

Stage I– coincides in time with the proliferation of borrelia at the site of penetration and in the lymph nodes;

Stage II– corresponds to the phase of spread of the pathogen through the blood throughout the body;

Stage III– chronic. During this period, one system of the body is predominantly affected (for example, nervous or musculoskeletal).

Stages I and II are called the early period of infection, and stage III is called the late stage. There is no clear transition between stages; the division is somewhat arbitrary.

Stage I

Characterized by general and local manifestations. Common symptoms include: headache, pain and aches in muscles, joints, increased body temperature up to 38°C, chills, nausea, vomiting, general malaise. Rarely there may be catarrhal phenomena: pain and sore throat, slight runny nose, cough.

Local symptoms are as follows: Soreness, swelling, itching, and redness appear at the site of the tick bite. The so-called ring-shaped erythema is formed - a specific symptom of tick-borne borreliosis. Detected in 70% of patients.

A red, dense formation appears at the site of the bite- a papule that gradually expands to the sides over several days, taking on the shape of a ring. In the center, the bite remains a slightly paler color, and the rim has a richer red color and rises above the unaffected skin.

In general, the redness zone has an oval or round shape with a diameter of 10-60 cm. Sometimes smaller rings may form inside the ring, especially if the size of the erythema is large.

Quite often, erythema does not cause the patient any discomfort, but it happens that this place itches and burns. It happens that ring-shaped erythema becomes the first manifestation of the disease and is not accompanied by general reactions. Additional annular erythema may appear, secondary, i.e. in places where there were no bites.

Erythema lasts several days, sometimes months, on average 30 days. Then it disappears on its own, leaving peeling and pigmentation in place of the erythema.

Other skin manifestations may include a rash like urticaria and the development of conjunctivitis.

Local symptoms are accompanied enlargement and soreness of regional lymph nodes, stiffness of the neck muscles, increased temperature, migrating joint-muscular pain.

Stage I is characterized by the disappearance of symptoms even without drug intervention.

Stage II

One of the manifestations of borreliosis is damage to the nervous system in the form of meningitis.

Characterized by damage to the nervous system, joints, heart, and skin. May last from several days to several months. By this point, all local and general manifestations of stage I disappear.

There are situations when tick-borne borreliosis begins immediately from stage II, bypassing ring erythema and general infectious syndrome.

Damage to the nervous system is manifested by three typical syndromes:

serous meningitis;

damage to the cranial nerves;

damage to the spinal nerve roots (radiculopathy).

Serous meningitis(inflammation of the meninges) is manifested by moderate headache, photophobia, increased sensitivity to irritants, moderate tension in the neck muscles, and significant fatigue. Typical symptoms of Kernig and Brudzinski meningitis may be absent altogether.

Possible emotional disorders, insomnia, impaired memory and attention. In the cerebrospinal fluid (cerebrospinal fluid), the content of lymphocytes and protein increases.

Of the cranial nerves, the facial nerve is most often affected. This is manifested by paralysis of facial muscles: the face looks distorted, the eyes do not close completely, food pours out of the mouth. Quite often the lesion is bilateral, sometimes one side is affected first, and after a few days or even weeks the other.

With tick-borne borreliosis, damage to the facial nerve has a good prognosis for recovery. Of the other cranial nerves, the visual, auditory, and oculomotor nerves are involved in the process, which is expressed, respectively, in deterioration of vision, hearing, development of strabismus, and impaired eye movements.

Damage to the roots of the spinal nerves makes itself felt clinically by severe shooting pains. In the torso area, the pain is girdling in nature, and in the extremity area, it is directed from top to bottom along the length. After a few days or weeks, the pain is accompanied by muscle damage (weakness develops - paresis), sensory disorders (increased or decreased general sensitivity), and tendon reflexes are lost.

Sometimes damage to the nervous system with tick-borne borreliosis may be accompanied speech impairment, unsteadiness and instability, the appearance of involuntary movements, trembling in the limbs, difficulty swallowing, seizures. Similar symptoms are observed in 10% of patients with tick-borne borreliosis.

Joint damage at this stage manifests itself as recurrent monoarthritis (one joint) or oligoarthritis (two or three joints). More often this concerns the knee, hip, elbow or ankle joints. They experience pain and limited mobility.

Heart damage also presents several clinical forms. This may be a disturbance in cardiac conduction (the most common are atrioventricular blockades), myocarditis and pericarditis are possible, manifested by palpitations, shortness of breath, chest pain, and heart failure.

Skin disorders in stage II are quite diverse: urticaria-type rash, secondary small ring erythema, lymphocytomas. Lymphocytoma is a rather specific sign of tick-borne borreliosis. This is a bright red nodule from a few millimeters to several centimeters, protruding above the skin level. Most often it forms on the earlobe, in the nipple area, and in the groin area. Lymphocytoma is a collection of lymph cells deep in the skin.

Stage II of tick-borne borreliosis can manifest itself by affecting other organs and systems, but much less frequently. Since borrelia are carried throughout the body in the blood, they can “settle” anywhere. Cases of damage to the eyes, bronchi, liver, kidneys, and testicles have been described.

Stage III

Such patients experience paresthesia and sensory disturbances.

It develops several months and sometimes years after the onset of the disease. It has several typical and known medical manifestations:

chronic arthritis;

atrophic acrodermatitis (skin lesions);

damage to the nervous system (encephalomyelitis, encephalopathy, polyneuropathy).

More often, the disease selects one of the body systems, i.e., damage to either the joints, or the skin, or the nervous system develops. But over time, a combined lesion is possible.

Chronic arthritis affects both large and small joints. Since the course of the disease is characterized by relapses, the joints gradually become deformed, the cartilage tissue becomes thinner and destroyed, and osteoporosis develops in the bone structures. Nearby muscles are involved in the process: chronic myositis develops.

Atrophic acrodermatitis is characterized by the appearance of bluish-red spots on the extensor surfaces of the knees, elbows, on the backs of the hands, and on the soles. The skin in these areas swells and thickens. When the process recurs and the disease persists for a long time, the skin atrophies and resembles tissue paper.

The damage to the nervous system in stage III is very diverse. It manifests itself in the motor (paresis), and in the sensitive (decreased, increased sensitivity, various types of pain, paresthesia), and in the coordination (impaired balance), and in the mental (impaired memory, thinking, intelligence) spheres.

Possible visual impairment, hearing impairment, epileptic seizures, and pelvic organ dysfunction. Patients almost constantly feel weak, lethargic, and are haunted by emotional disorders (in particular, depression).

Chronic borreliosis

If tick-borne borreliosis is not treated, it becomes chronic, characterized by recurrence of the process. The disease occurs with a gradual wave-like deterioration of the condition.

Of the known clinical syndromes that develop during the chronic course of the disease, the most common are:

• lymphocytomas;

  atrophic acrodermatitis;

  multifocal damage to the nervous system (any structure of the nervous system can be involved in the process).

Tests for borreliosis

The diagnosis of tick-borne borreliosis is based on clinical data(history of tick bite, presence of ring-shaped erythema) and data from laboratory research methods. But since a tick bite can go unnoticed, and the disease can occur without ring-shaped erythema and manifest itself only in stage II, laboratory diagnostic methods sometimes become the only way to confirm tick-borne borreliosis.

Borrelia itself is difficult to detect in humans. They can be found in affected tissues or body fluids. This may be the outer edge of annular erythema, areas of skin with lymphocytoma and atrophic acrodermatitis (biopsy is performed), blood or cerebrospinal fluid. But the effectiveness of these methods does not exceed 50%.

Therefore, indirect diagnostic methods are currently used:

polymerase chain reaction method(search for Borrelia DNA in blood, cerebrospinal fluid, synovial fluid);

serological diagnostics- indirect immunofluorescence reactions (IRIF), enzyme-linked immunosorbent assay (ELISA), immunoblotting (can detect antibodies to Borrelia in blood serum, cerebrospinal fluid and synovial fluid). To confirm the diagnosis, it is necessary that the initial antibody titer be at least 1:40 or there is a 4-fold increase in 2 sera taken at least 20 days apart.

Of course, the search for DNA fragments is somewhat more accurate than serological reactions. The latter can give false-positive results in patients with syphilis, rheumatic diseases, and infectious mononucleosis.

Seronegative variants of tick-borne borreliosis are also found, and in the early stages, in 50% of cases, serological testing does not confirm the infection. Such situations require dynamic research.

Treatment of borreliosis

Treatment of tick-borne borreliosis depends on the stage of the disease I. Of course, it is most effective in stage I.

Two directions are used:

etiotropic- impact on the pathogen (antibiotic therapy);

symptomatic and pathogenetic– treatment of damage to organs and systems (nervous system, heart, joints, etc.).

Oral antibiotics are used as etiotropic treatment in stage I(at the doctor's choice). Application period is 10-14 days. In no case should you reduce the dosage or shorten the duration of use, as this leads to the survival of some borrelia, which will multiply again.

In stage II, parenteral use of antibiotics is indicated to ensure a destructive concentration of the drug in the blood, cerebrospinal fluid, and synovial fluid. The duration of antibiotic use in this case is 14-21 days. In 85-90% of cases, this cures tick-borne borreliosis.

If there is no effect from the use of one or another antibiotic, there is no positive dynamics in the study of cerebrospinal fluid, then it is recommended to change the antibiotic to another.

Preventive antibiotic therapy is also carried out. It is indicated for people who seek medical help within 5 days from the moment of a tick bite, provided that the tick was brought with them (or was removed in a medical facility), and during examination, Borrelia was found in the tick (under a microscope). Such preventive measures allow you to avoid the disease in 80% of cases.

Symptomatic and pathogenetic treatment involves the use of antipyretic, detoxification, anti-inflammatory, antiallergic, cardiac, restorative, vitamin and other drugs. It all depends on the clinical form and stage of the disease.

Consequences of borreliosis

If the disease is detected in stage I and adequate treatment is carried out, then in most cases complete recovery occurs.

Stage II is also curable in 85-90% of cases without leaving any consequences.

With late diagnosis, an incomplete course of treatment, or defects in the immune response, the disease can develop into Stage III or chronic form. This course of tick-borne borreliosis, even with repeated courses of antibiotic therapy, complete pathogenetic and symptomatic treatment, does not allow the patient to fully recover.

The condition improves, but functional impairments remain that can cause disability:

persistent paresis - decreased muscle strength in the legs or arms;

sensitivity disorders;

facial deformation caused by damage to the facial nerve;

hearing and vision impairment;

severe unsteadiness when walking;

epileptic seizures;

joint deformation and dysfunction;

heart failure;

Of course, not all of these symptoms will necessarily be present in every patient with stage III or the chronic form.

Sometimes even in advanced cases, significant improvement and, albeit slow, recovery are possible.

Tick-borne borreliosis is a dangerous infectious disease that can develop unnoticed by the patient. Especially if the tick bite was not noticed.

Characterized by a specific symptom in the initial stage– annular erythema and a very diverse clinical picture of damage to various organs and systems (mainly nervous, cardiac and joints).

It is confirmed mainly by laboratory diagnostic methods.

It can be effectively treated with courses of antibiotics if used early. Otherwise, it can become chronic and leave behind irreversible functional impairment. published.

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Lyme disease (tick-borne borelliosis, Lyme borreliosis) refers to natural focal, infectious, predominantly vector-borne diseases with various variants of clinical manifestations. Symptoms are caused by an immune response to bacteria entering the body.

The most common symptoms of tick-borne borreliosis are fever, headache and a characteristic skin rash called erythema Afzelius or erythema migrans. In some cases, the infectious process affects the joints, cardiac tissue and nervous system.

With timely initiation of treatment, the disease can be completely cured without the risk of chronicity and the development of complications. In the later stages of Lyme borreliosis, the disease is difficult to treat and often ends in disability and even death.

Lyme disease: history

The infection got its name in honor of the city of Lyme, where an outbreak of the disease with characteristic symptoms was first recorded in 1975. In 1991, borreliosis was included in the official list of nosologies common in the Russian Federation.

The causative agent of infection

The causative agent of the infection is gram-negative microorganisms Borrelia, belonging to the Spirochaetaceae family. In Russia and European countries, the predominant causative agents of the disease are Borrelia garinii and Borrelia afzelii; in the United States, Borrelia burgdorferi is the causative agent of borreliosis.

Distributors and carriers of the infectious agent are ticks of the genus Ixodes, the infection rate among which varies from 10 to 70%. Lyme borreliosis is considered one of the most common diseases transmitted to humans through tick bites.

Disease prevalence and risk groups

The disease is widespread in Asia, Europe and North America. In Russia, 6-8 thousand people are infected with it every year. The pathology does not know age and can manifest itself in any person with whom an infected tick has been in contact. Children and adolescents, as well as adults aged 25 to 45 years, are at risk, especially those whose professional activities involve working in the forest.

Risk factors and natural reservoir

Carriers of bacteria (reservoir of infection) are domestic and wild animals, most often rodents and mammals (sheep, goats, dogs) that look outwardly healthy, but it is quite difficult to determine whether they carry the bacteria. Bacterial carriers (ticks) become infected from sick animals.

The highest incidence of infection is observed in the spring and summer. Ticks are most active from April to October, however, in recent years, cases of late (November-December) and early (March) cases of tick bites have become more frequent, which is facilitated by climatic warming and the adaptation of arthropods to harsher living conditions.

Risk factors for infection

Frequent walks in the forest or forested areas, wearing open clothing, barbecues and picnics in “wild” places.

Prolonged presence of the tick in the human body (more than 12 hours). It has been proven that with early removal of an attached tick from the body, the risk of infection is significantly reduced. At the same time, even when removing a tick crawling on the body, infection with Lyme infection cannot be ruled out.

Immunity

Intrauterine (passive) immunity against infection is not developed in the human body.

After infection, active immunity is unstable and there is a possible risk of recurrent disease after a season or several years.

Possible routes of transmission

Transmissible - the most common route of transmission - the ixodid tick feeds on the blood of an animal with borreliosis, as a result of which it becomes infected. Also, hatched tick larvae may already be infected if the female tick is infected. When a tick bites, the bacterium penetrates the wound along with the feces and saliva of the arthropod, and then enters the bloodstream of the human body.

Foodborne – transmission of infection through the milk of sick animals, in particular goats.

The transplacental route is the rarest option. Bacteria are transmitted from a sick mother to the fetus during pregnancy.

Classification

Based on the clinical course of the disease, three stages are distinguished:

I – local or local infection (erythema and non-erythema forms);

II – dissemination or divergence of the pathogen throughout the body (cardiac, meningeal, neuritic, febrile and mixed forms);

III – persistence or long-term survival of borrelia in the human body (chronic borrelia arthritis, atrophic acrodermatitis, etc.).

According to the level of severity of painful phenomena, 4 forms of the disease are distinguished:

• moderate severity;

• extremely heavy.

According to symptoms of infection:

seronegative (anti-borrelia antibodies are present in the diagnostic titer in the blood);

seropositive (specific antibodies are not detected).

Processes in the human body

The causative agent of Lyme disease enters the human body along with the saliva of the tick. From the site of the bite, it spreads through the lymph and blood flow to the joints, lymph nodes and internal organs. The infection spreads throughout the body and involves the lining of the brain in the pathological process. When bacteria die, endotoxin is released, triggering immunopathological reactions. Under the influence of irritation of the immune system, the local humoral and cellular response is activated. IgM and IgG antibodies are produced in response to the appearance of the flagellar flagellar antigen of bacteria.

As the disease progresses, the set of antibodies to borellium antigens expands, which entails long-term production of IgG and IgM. The proportion of circulating immune complexes increases. These complexes are formed in the affected tissues and activate inflammatory factors. The disease is characterized by the formation of lymphoplasmatic infiltrates in the lymph nodes, spleen, skin, subcutaneous tissue, peripheral ganglia and brain.

Tick-borne borreliosis: symptoms

Incubation period.

At the onset of the disease, an incubation (hidden) period is observed, lasting 7-14 days.

Local infection

After passing the incubation stage, the disease passes into the stage of local infection, in which skin manifestations and intoxication phenomena are noted with a duration of up to 30 days.

After a tick bite, on average, a week later, an itchy, painful red papule is formed, which is characterized by peripheral growth (erythrema migrans). When the erythrema expands, it forms a specific ring with a diameter of 10 to 60 cm. The expansion of the erythrema can occur within one to two months. Patients may experience burning and itching in this area. In place of the erythrema, a pigment spot and peeling remain.

The general infectious syndrome is characterized by headache, fever, increased body temperature, pain in bones, joints, muscles (especially cervical), and general malaise.

Other symptoms are dry cough, urticaria, rhinitis, conjunctivitis, pharyngitis, regional lymphadenitis, small and pinpoint ring-shaped rashes. Therefore, borreliosis can be confused with colds, which adversely affects its further treatment.

Disseminated stage.

Develops over the next 3-5 months. There are such variants of the course of the disease as febrile, cardiac, neuritic, meningeal and mixed.

Persistence stage.

At this stage, chronic Lyme arthritis, acrodermatitis atrophica and other complications develop.

Non-erythematous form.

Most often associated with damage to the nervous and cardiovascular systems:

In addition to damage to the nervous and cardiovascular systems, other systems and organs can be involved in the pathological process:

Joints: arthralgia and myalgia of a migrating nature, arthritis (mainly characteristic of large joints).

Skin: erythema migrans, benign dermatosis (erythema migrans).

Eyes: conjunctivitis, choreoretinitis, iritis.

Genitourinary system: protenuria (the presence of protein in the urine), microhemoturia (the presence of blood in the urine), testicular orchitis.

Digestive organs (hepatitis, hepatolienal syndrome).

Respiratory organs (sore throat, bronchitis).

The development of chronic Lyme borreliosis occurs six months to two years after infection. Borrelia can be stored in the human body for 10 years; the reasons for their such high survival rate are unknown. Even intensive antimicrobial treatment does not allow the development of the disease to be brought under control; if the immune system is weakened, relapses of infection are possible.

Three options for the consequences of tick-borne borreliosis are considered:

Atrophic acrodermatitis: manifests itself in the appearance of red lesions on the skin of the extremities. Subsequently, atrophic changes are localized here. The skin becomes thin and wrinkled, with scleroderma-like changes and telangiectasia.

Benign lymphocytoma: the appearance of a red-blue plaque or node with rounded contours on the skin of the ears, face, armpit or groin area. In rare cases, malignancy to lymphoma occurs.

Chronic Lyme arthritis is the most common variant. In this case, joint damage is observed, which is recurrent in nature. In this case, the synovial membrane and periarticular tissue are affected, which entails the development of enthesopathies, bursitis, and tendonitis. The clinical picture of the disease is similar to rheumatoid arthritis. Osteoporosis, thinning and destruction of cartilage tissue with loss of function of the affected joint, is observed.

In addition to joint damage, neurological symptoms are noted: chronic fatigue, dementia, polyneuropathy, encephalopathy, chronic encephalomyelitis.

If the infection enters the body of a pregnant woman, miscarriage and intrauterine death of the fetus are possible. If the fetus survives, the child will most likely be born premature, with congenital heart pathologies, delayed motor and mental development.

The stage of the disease is not always traceable. Sometimes only the stage of local reaction is noted. In children, Lyme disease develops with the same symptoms as in adults, but the child cannot always correctly voice his health complaints. Laboratory diagnostics play a key role.

Tick-borne borelliosis: diagnosis

Anamnesis. Typically, the patient indicates a tick bite after visiting parks and forest areas.

Early symptoms of the disease (skin erythrema, colds).

Testing for tick-borne borelliosis: determination of the antibody titer in the blood (a titer of 1:64 or higher indicates this diagnosis).

The disease can be diagnosed in later stages using an ECG, EEG, skin biopsy and joint radiography.

It is imperative to exclude diseases that have a similar clinical picture: rheumatoid arthritis, serous meningitis, tick-borne encephalitis and others.

Treatment

Etiological treatment of tick-borne borreliosis (Lyme disease).

When a diagnosis is made at an early stage of the disease, antibiotics from the tetracycline group (Doxycycline, Tetracycline) are prescribed for 14 days. If the child does not tolerate the above medications, Amoxicillin is prescribed as a replacement.

At further stages of the disease, with the development of neurological, articular and cardiac lesions, the patient is treated with cephalosporins and penicillins for 3-4 weeks.

In some cases, taking antibiotics can cause the Jarisch-Herxheimer reaction, which is characterized by an exacerbation of the signs of spirochetosis associated with intense death of bacteria and the penetration of endotoxins into the blood. In particular, the patient experiences:

headache;

• drop in blood pressure;

• temperature increase;

  myaglia and other symptoms.

If a patient experiences a Jarisch-Herxheimer reaction, antibiotic therapy is suspended for a certain time and then resumed at the previous dosage. In extremely severe cases, hormonal treatment is used.

Pathogenetic treatment of Lyme disease

For general infectious symptoms: oral and intravenous decongestion therapy - infusion of saline, glucose, taking antipyretic drugs.

For meningitis: intravenous dehydration therapy - Ringer's solution, Trisol.

For joint damage: analgesic and anti-inflammatory therapy - NSAIDs, analgesics.

In severe cases of the disease: hormonal therapy.

Forecast

If treatment for tick-borne borelliosis begins at its early stage of development, the chances of a complete recovery of the patient will be very high. The chronic development of Lyme disease can lead to human disability and even death as a result of irreversible changes in the cardiovascular and nervous systems. After completing the course of treatment, the person remains registered with an infectious disease specialist and other doctors.

Prevention of tick-borne borreliosis

Preventive measures are non-specific and consist of preventing a tick bite and stopping the nutritional route of infection:

For walks in the forest and park, you should dress in thick clothing in light shades.

Clothing should fit well to the body at the ankles, wrists and neck.

Pants should be tucked into socks and boots.

Be sure to wear a hat.

To repel ticks, it is necessary to apply repeoents to clothes and skin: “Deta”, “Off” or others.

Try to avoid tall bushes, thickets and weeds; if you cannot get around the obstacle, make a path for yourself using a stick or branch, tapping on the plants (in order to throw ticks from them to the ground).

After every hour you pass on the road, carefully examine each other, especially the area of ​​the chest, armpits and neck: usually the tick does not attach itself immediately, but chooses the most convenient place for this.

Do not remove grass, branches and plants from the forest - they may contain ticks.

Be sure to boil milk from unknown and questionable sources.

At the state level, prevention of Lyme disease is carried out by mowing recreation areas and areas near park and forest paths, as well as treating the area with special insecticidal preparations.

What to do if you detect an attached tick?

Try to remove the arthropod as quickly as possible, preferably in a hospital setting. When removing the tick yourself, use an anti-tick module or a loop of thread, which is carefully placed over the tick’s body and pulled out, and the resulting wound is treated with an antiseptic. It is important to try to remove the entire tick, and if this does not work, collect its remains in a jar with a lid.

Go to a medical facility and show the bite site to a specialist. Health workers will check whether all parts of the arthropod have been removed from the skin and will issue a referral for analysis of the tick to determine if it is infected.

Take the tick to the laboratory for testing. This must be done immediately, maximum – a day after extraction. Arthropods must be stored in the refrigerator in a tightly closed container.

Take prophylactic antibiotics prescribed by your doctor. Usually, their use is prescribed even before the results of the study are received (“Amoxicillin” or “Doxycycline” for 5-10 days). You should not ignore your doctor’s instructions, since the disease is characterized by many severe manifestations, and the results of tick examination may be false negative.

Signs of the disease were first diagnosed in the United States in 1975. Clinical studies have revealed the presence of juvenile rheumatoid arthritis in patients. In 1977, the causative agent, the ixodid tick, was identified, and medical reference books were replenished with articles describing the new disease.

The observations and comprehensive study of the disease that followed this event in the best clinics and research centers in the world led to the creation of the most effective methods for diagnosing and treating borreliosis. And today, despite the means found to combat the disease, scientists and doctors continue their search, hoping to create a powerful vaccine that can prevent infection with tick-borne borreliosis forever.

Signs of borreliosis

On the territory of Russia, the spread of two types of ixodid ticks has been noted: taiga and dog. The first species is found in the forests of the Far East and Siberia, the second lives in the European part of the country. The encounter with an insect itself can go unnoticed, because only a portion of the mites are infected. If you are unlucky and the virus is transferred into the human blood, it is important to know exactly the main visual sign of borreliosis:

At the site of the bite, a ring-shaped redness, erythema appears, the edges of which are slightly raised, the center is colored less intensely than the circle formed by inflammation.

A natural continuation of the lesion is itching or pain in the area where the erythema is located. It is difficult to identify the disease in a timely manner, since the symptoms of borreliosis truly manifest themselves only one, or maybe two weeks after receiving the bite. Based on the severity and severity of symptoms, the disease is divided into three stages.

1st stage(local infection) is observed in 40-50% of infected people. Taking into account the incubation period, it appears in the first month after the bite and has the following symptoms:

• ring-shaped migrating erythema
• temperature rise to 39-40 degrees
• fever
• headache
• joint and muscle pain
• general weakness
• rarely nausea and vomiting

Immediately contacting a doctor, even if you have doubts that you were bitten by an ixodid tick, will help you quickly begin treatment. Only at the first stage is there a real, one hundred percent guarantee of complete relief of the effects of Borrelia.

2nd stage observed in 10-15% of patients. In the absence of proper treatment, it manifests itself (after a long time) as follows:

• cardiopalmus
• pain in the heart area
• liver and kidney damage
• acute conjunctivitis
• angina
• bronchitis
• hives

Since borrelia can settle in any human organ, the clinical picture of the second stage is not a constant and unchanging phenomenon. The general trend is this: where the infection sits, it hurts more.

3rd stage is formed several months after the end of the first two. The following symptoms of tick-borne borreliosis at this stage are described:

• relapsing course
• weakness and malaise
• increased excitability or depression
• sleep disturbance
• damage to various systems and organs

The most severe stage, leading to life-threatening changes and even death. It is difficult to treat and becomes chronic.

How is it diagnosed?

The system for diagnosing any disease involves a comprehensive examination of the patient. Even with a common cold, they take the temperature, listen to breathing and examine the throat. Infections with more serious consequences than a runny nose and cough require serious laboratory techniques. That is why the diagnosis of tick-borne borreliosis consists of:

• medical history (conversation with a doctor to identify the location of the tick bite)
• blood test (repeated after 20-30 days)
• serological method (detection of antibodies to Borrelia)
• solid phase ELISA
• PCR (helps detect Borrelia protein in synovial fluid, serum and tissues)

Having become familiar with the methods for diagnosing borreliosis, it becomes obvious that the main culprit of the disease is Borrelia, and all procedures are aimed at searching for it.

These small convoluted bacteria, belonging to the spirochete family, live in the nutrient medium of wild and domestic animals, including cattle. The ixodid tick, feeding on the blood of an infected animal, transports Borrelia into the human body with its own feces. By scratching a tick bite, we involuntarily help bacteria enter the bloodstream and then settle in our internal organs.

There is another form of borreliosis - without erythema. This means that if you admit the possibility of getting an ixodid tick bite, but do not observe its visual manifestation, still, do not be lazy to visit a doctor and carry out all the necessary tests.

Early diagnosis of the disease is very important. Only it allows you to avoid terrible consequences leading to irreversible physical and, more dangerous, mental changes in the body.

Treatment of borreliosis

Considering the serious disruptions in the functioning of organs that are fraught with Lyme disease, named after the city of Lyme in the state of Connecticut, you should pay close attention to the signs that appear and, without delaying for long, immediately consult a doctor. Modern scientific and practical medicine, provided that treatment is started early, guarantees a favorable prognosis upon its completion.

Treatment of borreliosis is the prerogative of infectious disease doctors. The basis of the treatment method at any stage of the disease is antibacterial therapy. Only the dose, frequency and duration of taking antibiotics change.

Under the influence of antibiotics, massive death of Borrelia occurs, which can lead to intoxication of the body. If such signs appear, the medication should be temporarily stopped. In general, with regular and correct use of medications prescribed by a doctor, it is quite easy to cope with borreliosis at the first stage. It’s worse if the start of treatment is missed and borreliosis moves to the next stage.

There have been cases where the first stage of the disease does not manifest itself at all. Erythema is mild and disappears quickly, there are no signs of general malaise or headache. However, the process continues inside, borrelia multiply and spread throughout the body. You should not hope for chance and a lucky break; it is better to go to the doctor and make sure that the bite is not dangerous.

Consequences of borreliosis

All the severe consequences that characterize the disease borreliosis provoke the 2nd and 3rd stages of the disease, provided that appropriate treatment was not carried out at the 1st stage.

Borrelia negatively affects the entire human body, affecting the nervous and cardiovascular systems at the 2nd stage, and attacks the musculoskeletal system at the 3rd stage.

If we move away from generally accepted concepts to specifically expressed complications of borreliosis, it looks like this:

• cardiovascular system - severe arrhythmia, fatigue
• nervous system - multiple sclerosis, development of dementia in children, general impairment of mental functions of the body, paralysis of peripheral nerves (distortion of facial expressions)
• musculoskeletal system - rheumatoid arthritis, muscle atrophy, periodic joint inflammation

As we see, any form of complication of borreliosis inevitably leads to a change in lifestyle and limits a person’s mental and physical capabilities. The consequences of the disease are especially dangerous for children. A child who is just entering the vast world of emotions, knowledge, and hobbies is deprived of everything. Unprepared for such destructive attacks of bacteria, the body cannot cope with the attack and becomes seriously disturbed. This is an eternal pain for both parents and children, even if the kids do not realize it mentally. And only taking timely preventive measures can prevent destruction that is detrimental to your child, stop the penetration of harmful bacteria into the body and protect against the serious consequences of this insidious disease.

Prevention of borreliosis

Almost 40 years have passed since the discovery of borreliosis, but still no effective vaccine has been obtained that can prevent infection immediately after a tick bite. And this despite the fact that the ixodid tick is a carrier of another serious disease - encephalitis. As you know, there is a vaccine against encephalitis and it is effective. So what to do, how to protect yourself from borreliosis, and can this be done by means and methods accessible to everyone?

Precautionary measures

The main prevention consists of taking protective measures at home. If you are planning a trip to nature or you live in areas where the ixodid tick is epidemiologically widespread, you should do the following:

• wear shirts and other clothes with long sleeves, trousers made of thick material, hats (hats, scarves), gloves, high boots for a walk in places where insects gather
• treat all clothing with special means of protection against insect bites
• If a tick is already found on the body, carefully and very carefully, trying to prevent the head of the insect from coming off, remove it using tweezers or your fingers
• remove with slow twisting movements
• It is forbidden to crush or drag the insect vertically
• after removal, the wound is washed, small particles, if observed, are cleaned, hands are disinfected

The ixodid tick did not appear out of nowhere and people have long been familiar with its bites. There are several traditional ways to remove a tick: lubricate the tick and the bite site with vegetable oil, smoke the insect with cigarette smoke, or drip wax. Attention: do not resort to traditional methods unless absolutely necessary. There is a risk that the tick, experiencing a lack of breathing, will regurgitate the contents of the stomach into the human blood and infection will occur.

It is an infectious disease common in certain areas inhabited by the microorganism that causes it. The correct and full name of this infection is systemic tick-borne borreliosis, but in addition to this, the following names are used to designate the disease: tick-borne meningopolyneuritis, tick-borne borreliosis, ixodid borreliosis, chronic migratory erythema, erythemal spirochetosis, Bannowart's syndrome and Lyme disease. However, in everyday life the short names most often used are borreliosis, Lyme disease or Lyme borreliosis.

The infection occurs in stages, affecting the joints, nervous system and sometimes the heart, and is completely curable if antibiotic therapy is started within a short period of time after the onset of the disease.

A distinctive feature of borreliosis is that the infection is not transmitted from a sick person to a healthy person, and infection occurs only through the bite of a tick that carries the causative microbe. Borreliosis can affect people of any gender and age, including young children and the elderly.

Borreliosis - general characteristics, history of discovery and names of the infection

The infection received the name “borreliosis” from the Latin name of the spirochete – Borrelia burgdorferi, which is its causative agent. And the name Lyme disease was given by the name of the city of Lyme in Connecticut, where an outbreak of infection was first registered in 1975 and its main symptoms were described. All other names for this infection are derived either from borrelia (borreliosis), or from the leading clinical signs (tick-borne meningopolyneuritis), or from the name of ticks that carry spirochetes (ixodic or tick-borne borreliosis, etc.).

Lyme disease was discovered after a study of Connecticut teenagers, who had juvenile arthritis 100 times more often than their peers from other areas of the United States. Doctors and scientists became interested in this anomaly, examined the children, took samples of synovial fluid from the joints, from which they were able to inoculate the spirochete Borrelia burgdorferi, which turned out to be the causative agent of the disease.

Borreliosis occurs in three successive stages, developing at different intervals after infection. At the first stage (acute), a person develops general infectious symptoms of intoxication (fever, headaches and muscle pain, weakness, drowsiness, etc.) and erythema migrans. Erythema forms at the site of a tick bite and is a spot that is constantly increasing in diameter with a bright red outer rim and a light inner part. This first stage of borreliosis develops a few days or weeks after a tick bite and infection with spirochetes, and lasts up to 1 month. After completion of the first, acute stage of borreliosis, either recovery occurs, or the infection becomes chronic and stages 2 and 3 develop.

At the second stage of borreliosis, a person develops damage to either the nervous system or the heart. As a result of damage to the nervous system, a person develops peripheral neuropathies (numbness of the limbs, loss of sensitivity in certain areas of the arms and legs, etc.), meningitis, radiculitis, etc. And damage to the heart is characterized by the development of palpitations, pain in the heart, blockades, etc. The second stage of infection can last up to six months.

At the third stage of borreliosis, a person develops arthritis, which is combined with damage to either the nervous system or the heart, depending on which organ was involved in the pathological process at the second stage. In addition to arthritis, atrophic dermatitis often develops at the third stage of borreliosis.

A distinctive symptom of the first stage of borreliosis is erythema, which appears on the body at the site of the tick bite in 80% of cases. Erythema first appears as a small red nodule or vesicle, from which redness gradually spreads around the perimeter, forming a kind of rim. The surface of the skin inside the rim may be red or normal. The diameter of the erythema is constantly increasing, which is why it is called migratory. As a rule, the erythema is round in shape, but can sometimes be oval. Erythema usually increases to 20 cm in diameter, and in rare cases up to 60 cm. In the area of ​​erythema, the skin is very itchy, there is a burning sensation and severe pain. Since erythema appears at the site of a tick bite, it is most often localized on the stomach, lower back, legs, armpits, neck or groin.

General infectious symptoms of intoxication in combination with erythema are specific for borreliosis, allowing one to suspect this infection. In addition to erythema, a rash, urticaria, as well as pinpoint and ring-shaped rashes may appear on the skin.

In 5–8% of people at the first stage of borreliosis, signs of brain damage appear, such as:

• Headache;
• Nausea;
• Vomiting more than 2 times a day;
• Photophobia;
• Increased sensitivity of the skin (even a light touch causes a burning sensation, pain, etc.);
• Tension of the neck muscles;
• Head thrown back;
• Legs pressed to stomach.

In very rare cases, the first stage of borreliosis is manifested by anicteric hepatitis with the following symptoms - loss of appetite, nausea, vomiting, pain in the liver, increased activity of AST, ALT and LDH in the blood.

Thus, the first stage of borreliosis can occur with the development of very diverse and polymorphic symptoms, among which erythema migrans is considered constant. Other symptoms (except erythema) may vary. In approximately 20% of cases, erythema migrans is the only clinical symptom of borreliosis.

The first stage lasts from 3 to 30 days, after which it either passes into the second or ends with recovery. The probability of complete recovery when adequate antibiotic therapy is started at the first stage is 80%. If recovery does not occur, then the infection enters the second stage. Moreover, the second stage will develop, even if the first was asymptomatic and was not properly treated.

Stage II of borreliosis

At the second stage of borreliosis, predominant damage to the nervous system or heart develops, and depending on which organ is involved in the pathological process, neurological or cardiac symptoms appear.

Damage to the nervous system in the second period of borreliosis is characterized by the development of meningitis or meningoencephalitis, combined with cranial nerve paresis and peripheral radiculopathy. With meningitis, a person develops a severe throbbing headache, repeated vomiting, neck tension, photophobia and elevated body temperature. And with meningoencephalitis, the indicated meningeal symptoms are accompanied by disorders of sleep, memory, concentration and emotional lability.

Peripheral radiculopathy is manifested by wandering pain from the neck to the arms and from the lower back to the legs, as well as impaired sensitivity in the extremities (numbness, tingling, burning, etc.) and a decrease in the strength of some muscles.

A distinctive feature of borreliosis is the combination of meningitis with cranial nerve palsies and radiculopathy. This most common symptom complex of neurological disorders at stage 2 of borreliosis is called Bannovart's lymphocytic meningoradiculoneuritis. If treatment with antibiotics is not started at the second stage, borreliosis meningitis can last up to several months.

In rare cases, damage to the nervous system during borreliosis is manifested by neuritis of the oculomotor, optic and auditory nerves.

At the second stage of borreliosis, in addition to the nervous system, the heart is also affected, which, however, is observed much less frequently. Heart damage can occur as a transient atrioventricular block, pericarditis or myocarditis. When borreliosis affects the heart, a person develops the following symptoms:

• Heartbeat;
• Chest pain of a compressive nature;
• Dizziness.

Damage to the nervous system and heart are most characteristic of the second stage of borreliosis. However, in addition to them, skin lesions may develop, occurring in the form of capillaritis, rashes and a single benign lymphocytoma.

Erythema and benign lymphocytoma of the skin are the most specific symptoms of borreliosis. Externally, such a lymphocytoma looks like a single convex nodule on the skin, painted in a bright crimson color and slightly painful when touched. Lymphocytomas can be localized on the face, genitals and groin area.

In addition to the above symptoms, at the second stage of borreliosis, nonspecific clinical manifestations may develop, such as:

• Conjunctivitis;
• Iritis;
• Chorioretinitis;
• Panophthalmos;
• Angina;
• Hepatitis;
• Splenitis (inflammation of the spleen);
• Orchitis (inflammation of the testicles);
• Microhematuria (blood in the urine);
• Proteinuria (protein in urine);
• Weakness;
• Severe fatigue.

III stage of borreliosis

The third stage is characterized by the development of arthritis, atrophic acrodermatitis or neurological syndromes similar to neurosyphilis. Joint damage at the third stage of borreliosis can occur in three forms:
1. Arthralgia (migrating pain moving from one joint to another);
2. Benign recurrent arthritis;
3. Chronic progressive arthritis.

Migrating arthralgia is recorded in 20–50% of cases and is almost always combined with muscle pain. Moreover, the most severe pain develops in the neck muscles. With arthralgia, there are no inflammatory changes in the joints, but the pain is so severe that the person is literally immobilized. Such joint pain continues for several days in a row, is combined with weakness, fatigue and headache, after which it suddenly and independently disappears. From time to time a person experiences similar attacks of arthralgia.

When benign recurrent arthritis develops, it usually affects the knees or other large joints. The pathological process involves one or a maximum of 3 joints. Arthritis occurs with alternating relapses and remissions. Relapses last 1–2 weeks and are characterized by pain in the affected joints, swelling and limited mobility. Remissions last from several weeks to months. Moreover, as the disease progresses, the frequency of relapses decreases, and the duration of remissions increases. Within 4–5 years, relapses completely disappear, and arthritis ceases to bother the person. Due to the fact that arthritis can go into remission for a long time, it is considered benign.

Chronic arthritis affects several joints at once (more than three) and occurs as a constant inflammatory process. With this type of arthritis, a person experiences pain, swelling, poor mobility and limited movement in the affected joints, as well as erosion of cartilage and bones. Very often, the tissues surrounding the joint are involved in the pathological process, as a result of which arthritis is complicated by bursitis, ligamentitis, enthesopathies, osteoporosis, thinning of cartilage, as well as osteophytosis (layering of a loose inflammatory mass on the bone). Sometimes chronic borreliosis arthritis is combined with pannus (inflammation of the cornea of ​​the eye).

In addition to joint damage, in the third period of Lyme disease, a pathological process develops in the skin, occurring as atrophic acrodermatitis or focal scleroderma.

Acrodermatitis atrophica begins with the appearance of red-blue patches on extensor surfaces such as the knees, elbows, dorsum of the hands, and soles. In the area of ​​the spots, a dense inflammatory infiltrate, swelling and impaired lymph outflow in the affected area can form. This inflammatory phase continues for years and slowly turns into a sclerotic phase. In the sclerotic phase, the skin on which there were red and blue spots atrophies and becomes like crumpled thin paper.

In the third stage of borreliosis, atrophic acrodermatitis in 30% of cases is combined with damage to the joints, and in 45–50% with late neurological complications, such as disturbances of sensitivity or movement. The most characteristic late neurological complications of stage III borreliosis are chronic encephalomyelitis, spastic paraparesis, chronic axonal polyradiculopathy, memory loss, and dementia.

Chronic encephalomyelitis is characterized by constant headaches, fatigue, dizziness, nausea, periodic vomiting, convulsions, hallucinations, as well as impaired memory, attention, speech, coordination of movements, sensitivity, etc.

Spastic paraparesis is characterized by an increase in muscle tone in various parts of the body with the development of uncontrolled pathological reflexes and movements.

Chronic axonal polyradiculopathy is characterized by the following manifestations:

• Muscle weakness in the lower extremities (hands, feet). With severe weakness of the leg muscles, stepping develops - “cock gait”;
• Decreased or complete loss of tendon reflexes;
• Impaired sensitivity in the final parts of the arms and legs, covering areas of the skin like “socks” and “gloves”. Sensitivity disturbance manifests itself in the feeling of goosebumps, burning, tingling, loss of the ability to feel temperature, vibration, touch, etc.;
• Violation of the coordinated functioning of blood vessels, as a result of which a person experiences attacks of palpitations, hypotension, impotence, etc.

Chronic Lyme disease

With chronic borreliosis, joint damage (arthritis), atrophic acrodermatitis or benign skin lymphocytoma develops. Arthritis can lead to complete destruction of the cartilage and bone of the joint, as a result of which the latter becomes functionally inferior and must be replaced with a prosthesis to maintain mobility.

Borreliosis (Lyme disease): incubation period, symptoms and manifestations of the disease - video

Borreliosis in children

The course of the disease and clinical signs in children are exactly the same as in adults. However, children are characterized by the development of meningitis as a manifestation of damage to the nervous system, while adults more often develop peripheral nephropathies (nerve paresis, radiculitis, etc.).

Due to the predominant damage to the central nervous system, after recovery from borreliosis, children may remain asthenovegetative reactions, such as mood instability, increased excitability and sleep disorders. These reactions disappear completely after some time.

Diagnosis of borreliosis

General diagnostic principles

• Serous meningitis, meningoencephalitis, polyradiculoneuritis or neuritis of the cranial nerves;
• Arthritis of one or more joints;
• Impairment of atrioventricular conduction of the heart II or III degrees, myocarditis or pericarditis;
• A single benign lymphocytoma on the earlobe or nipple;
• Chronic atrophic acrodermatitis.

Analysis for borreliosis (blood for borreliosis)

• Indirect immunofluorescence reaction (IRIF);
• Enzyme-linked immunosorbent assay (ELISA);
• Polymerase chain reaction (PCR);
• Immunoblotting.

When performing an ELISA test, the result can be positive or negative. Positive means that antibodies to borrelia have been detected and, accordingly, the person is infected with borreliosis. A negative test result means that a person does not have Borrelia in his blood.

When carrying out PCR and immunoblotting, Borrelia are detected directly and their quantity per unit volume of blood (most often 1 ml) is determined. Accordingly, if the analysis indicates that borrelia have been detected and their quantity is indicated, then this means the presence of borreliosis in a person.

The simplest, most accessible and quite effective tests for borreliosis are ELISA and RNIF, for which it is necessary to donate blood from a vein. However, for a reliable diagnosis, two studies should be performed with an interval of 4–6 weeks between them in order to determine not only the presence of infection, but also its dynamics.

Borreliosis - treatment

So, for the treatment of borreliosis at the first stage(within a month after the onset of clinical symptoms), the following antibiotic treatment regimens are used:

• Amoxicillin (Amosin, Ospamox, Flemoxin Solutab, Hiconcil, Ecobol) - take 500 mg 3 times a day for 10 - 21 days;
• Doxycycline (Xedocin, Unidox Solutab, Vidoccin, Vibramycin) - take 100 mg 2 times a day for 10 - 21 days;
• Cefuroxime (Axetin, Antibioxime, Zinnat, Zinacef, etc.) – take 500 mg 2 times a day for 10 – 21 days;
• Azithromycin (Sumamed, etc.) – take 500 mg once a day for a week (the least effective antibiotic);
• Tetracycline - take 250 - 400 mg 4 times a day for 10 - 14 days.

If neurological symptoms are present

• Doxycycline (Xedocin, Unidox Solutab, Vidoccin, Vibramycin) - take 100 mg 2 times a day for 14 - 28 days;
• Benzylpenicillin – administer 5,000,000 units intravenously every 6 hours (4 times a day) for 14–28 days;
• Chloramphenicol (Levomycetin) - taken orally or administered intravenously 500 mg 4 times a day for 14 - 28 days.

• Ceftriaxone (Azaran, Axone, Biotraxone, Ificef, Lendacin, Lifaxone, Medaxone, Rocephin, Torocef, Triaxone, etc.) - administered intravenously at 2000 mg 1 time per day for 2 - 4 weeks;
• Penicillin G – administered intravenously at 20,000,000 units once a day for 14–28 days;
• Doxycycline (Xedocin, Unidox Solutab, Vidoccin, Vibramycin) - take 100 mg 2 times a day for 21 days;
• Amoxicillin (Amosin, Ospamox, Flemoxin Solutab, Hiconcil, Ecobol) - take 500 mg 3 times a day for 21 days.

• Amoxicillin (Amosin, Ospamox, Flemoxin Solutab, Hiconcil, Ecobol) - take 500 mg 4 times a day for 30 days;
• Doxycycline (Xedocin, Unidox Solutab, Vidoccin, Vibramycin) - take 100 mg 2 times a day for 30 days (can be taken in the absence of neurological symptoms);
• Ceftriaxone (Azaran, Axone, Biotraxone, Ificef, Lendacin, Lifaxone, Medaxone, Rocephin, Torocef, Triaxone, etc.) - administered intravenously at 2000 mg 1 time per day for 2 - 4 weeks;
• Penicillin G – administered intravenously at 20,000,000 units once a day for 14–28 days.

• Amoxicillin (Amosin, Ospamox, Flemoxin Solutab, Hiconcil, Ecobol) - take 1000 mg once a day for 30 days;
• Doxycycline (Xedocin, Unidox Solutab, Vidoccin, Vibramycin) - take 100 mg 2 times a day for 30 days.

During treatment with antibiotics, a person may develop multiple rashes or several erythemas on the body, as well as develop a temporary exacerbation of symptoms. This should not be feared, since such a response from the body is called the Jarisch-Gersheimer reaction and indicates the success of the treatment.

If borreliosis has been detected in a pregnant woman, then she should take Amoxicillin 500 mg 3 times a day for 21 days. No other therapy is required, since this course of antibiotic therapy is sufficient to prevent transmission of the infection to the fetus.

In addition to antibiotic therapy, which is aimed at destroying borrelia in the human body, in the complex treatment of borreliosis, symptomatic treatment methods are used to help eliminate the painful manifestations of the infection. Symptomatic methods are used to improve the general condition and relieve symptoms that are poorly tolerated by a person.
itching

Prevention of infection

Since ticks live in grass and leaves, it is necessary to avoid being in places where you will have close contact with vegetation (forests, parks, etc.). If a person is going “out into nature,” then he should dress in light-colored clothing that covers the body as much as possible: a long-sleeved shirt, pants with an elastic band at the ankle, a scarf around the neck, a hood or cap on the head, etc. In addition, exposed areas of the body should be treated with tick repellents.

While in a forest or park, you should inspect your body for ticks every two hours. Also, while in nature, you need to sit in the grass as little as possible and have contact with the foliage of bushes and trees.

Prevention of borreliosis after a tick bite

• Doxycycline – 100 mg 1 time per day for 5 days;
• Ceftriaxone - 1000 mg 1 time per day for three days.

Lyme disease (borreliosis): prevalence and causative agent of infection, signs and manifestations (symptoms), complications, diagnosis (rapid test), treatment (antibiotics), prevention - video

Consequences of borreliosis