Info about European chronic (=late) borreliosis

General or non-medical topics with information and discussion related to Lyme disease and other tick-borne diseases.
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Info about European chronic (=late) borreliosis

Post by X-member » Sat 17 Dec 2011 14:48

I will give you info about European chronic (=late) Lyme in this topic!

I will also give you the European definition of chronic Lyme (I am soo tired of explaining it over and over again).

http://www.ncbi.nlm.nih.gov/pubmed/22153213
[Acrodermatitis chronica atrophicans can be difficult to diagnose.]

[Article in Danish]
Rosenlund S, Bækgaard N, Menné T.
SourceOrtopædkirurgisk Afdeling, Køge Sygehus, Lykkebækvej 1, 4600 Køge.

Abstract
A healthy 29 year-old man developed over four years a slowly increasing swelling and violet discolouring of the third toe on his left foot. He was examined by several specialists and an amputation was recommended since the condition was unknown and aggravating. On suspicion of Borrelia infection the patient was prescribed penicillin treatment for 28 days with convincing effect. Serologic tests showed increased Borrelia titer. Biopsy showed chronic inflammation without any suspicion of malignity. Denmark is endemic for borreliosis and per year approximately 50 cases develop acrodermatitis chronic atrophicans.

PMID:22153213[PubMed - as supplied by publisher]
Last edited by X-member on Sun 12 Feb 2012 15:15, edited 2 times in total.

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Re: Info about European chronic (=late) Lyme

Post by X-member » Sat 17 Dec 2011 14:57

Sorry, this article is in Swedish, but they say something interesting:

"Ny fästingöverförd sjukdom" (A new tick-transmitted disease)

http://www.lakartidningen.se/07engine.p ... leId=17076
Huruvida B miyamotoi är inblandad i uppkomsten av en del fall av svårbehandlad kronisk borrelios kommer nog också att bli föremål för studier
Translation (with google translate):
Whether B miyamotoi is involved in the onset of some cases of difficult to treat chronic Lyme disease will probably also be the subject of studies

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Re: Info about European chronic (=late) Lyme

Post by X-member » Sat 17 Dec 2011 15:03

The Swedish defintion of chronic Lyme:

http://www.fou.nu/is/alfvll/ansokan/108591
I det sena stadiet, som i obehandlat tillstånd kallas kroniskt, dominerar symtom från nervsystemet, leder och hud, varav kronisk NB idag är mycket ovanligt, medan kronisk Lyme artrit och acrodermatitits chronicum atrophicans (kronisk hudborrelios) förekommer oftare.
Translation (with google translate):
In the late stage, as in the untreated condition is called chronic, dominating symptoms from the nervous system, joints and skin, including chronic NB is now very rare, whereas chronic Lyme arthritis and acrodermatitits chronicum atrophicans (chronic "skin"borreliosis) are more frequent.
Last edited by X-member on Sat 17 Dec 2011 15:29, edited 1 time in total.

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Re: Info about European chronic (=late) Lyme

Post by X-member » Sat 17 Dec 2011 15:17

The German definition of chronic:

"Deutsche Borreliose-Gesellschaft e. V."

http://www.borreliose-gesellschaft.de/T ... elines.pdf
2.2.4 Chronic stage

The time differentiation between the early and late stages is arbitrary. Disease manifestations of Lyme borreliosis which occur more than 6 months after the start of infection are designated in this Guideline as late manifestations or as chronic.
Last edited by X-member on Sat 17 Dec 2011 18:11, edited 1 time in total.

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Re: Info about European chronic (=late) Lyme

Post by X-member » Sat 17 Dec 2011 15:25

http://www.grin.com/en/e-book/166179/pr ... me-disease
"Prolonged antibiotic therapy in PCR confirmed persistent Lyme disease"

Wolfgang Klemann, MD, PhD
Bernt-Dieter Huismans, MD, PhD
Stephan Heyl, MD, PhD

Abstract: We examined a sample of 90 individuals that had previously received a course of appropriate antibiotics for Lyme disease without experiencing full resolution of their symptoms and had evidence of persistent infection documented by PCR analysis.

Mean duration of symptoms was 9.5 years (range 1 - 40 years). The treatment was adapted to the individual case according to clinical response. Long term antibiotic therapy was initiated and patients were treated continuously for at least 6 months, in some cases several years of intermittent therapy was administered.

About 38,8% of the patients experienced full remission of symptoms while about 56,7% reported a significant improvement, 5,6% of patients were deemed refractory to therapy. Therapeutic modalities are discussed in detail.

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Re: Info about European chronic (=late) Lyme

Post by X-member » Sat 17 Dec 2011 17:53

The Norwegian definition of chronic/late/stage 3-Lyme:

http://tidsskriftet.no/article/1690011
Stadium 3

Denne betegnelsen brukes om ubehandlede infeksjoner som har vart i måneder eller år. Den vanligste formen i Europa er hudsykdommen acrodermatitis chronica atrophicans som debuterer som en blåaktig misfarging på ekstensorsiden av ekstremitetene. Senere utvikles ofte epidermal atrofi med tynn og papiraktig hud, av og til ledsaget av lokalisert sensorisk nevropati. Borreliaartritter kan også bli kroniske, mens kronisk hjerteaffeksjon med dilatert kardiomyopati er uhyre sjelden. Kronisk nevroborreliose er ikke entydig definert, men betegnelsen brukes ofte ved sykdomsvarighet over seks måneder og progredierende encefalomyelitt.
A not perfect translation (with google translate):
Stage 3

This term refers to untreated infections that have lasted for months or years. The most common form in Europe is skin disease acrodermatitis Chronica atrophicans who debuts as a bluish discoloration of ekstensorsiden (=outside I think) of the extremities. Later, often developed epidermal atrophy with thin paper-like skin, sometimes accompanied by localized sensory neuropathy. Lyme arthritis can also become chronic, and chronic heart involvement with dilated cardiomyopathy is extremely rare. Chronic neuroborreliosis is not clearly defined, but the term is often used by disease duration over six months, and progressive encephalomyelitis.

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Re: Info about European chronic (=late) Lyme

Post by X-member » Sat 17 Dec 2011 18:05

16 year old Swedish boy died from chronic/late/stage 3-Lyme.

But they do the most common "Swedish mistake" and only call it "Neuroborreliosis" (=stage 2).

Sorry, this article is in Swedish (use google translate if you are more curious):

"Stora brister då 16-åring dog i trolig neuroborrelios"
(Major shortcomings when 16-year-old died of probable neuro-borreliosis)

http://www.lakartidningen.se/07engine.p ... leId=17368
Den brist på samordning, helhetssyn, systematik och ansvarstagande som händelsen påvisar är enligt Socialstyrelsen inte acceptabel. Socialstyrelsen kräver nu att det berörda landstinget fastställer och tydliggör var ansvaret ligger för att hålla samman utredning och behandling av barn och ungdomar som söker sjukvården upprepade gånger med oklar och multifokal symtomatologi.
Translation (with google translate and me):
The lack of coordination, holistic, systematic and accountable to the incident demonstrates, according to the National Board is not acceptable. National Board of Health now requires that the county establish and clarify where responsibility lies in keeping the investigation and treatment of children and adolescents that repeatedly seeking care with unclear and multifocal symptomatology.

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Re: Info about European chronic (=late) Lyme

Post by X-member » Sat 17 Dec 2011 19:00

There is a big lack of good info about a disseminated B Afzelii-Lyme infection, but on the site (below) you can find info about symptoms (compared with B Garinii) and so on:

"Comparison of Findings for Patients with Borrelia garinii and Borrelia afzelii Isolated from Cerebrospinal Fluid"

http://cid.oxfordjournals.org/content/43/6/704.full.pdf

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Re: Info about European chronic (=late) Lyme

Post by X-member » Sat 17 Dec 2011 19:11

More Norwegian info:

http://www.utposten.no/Portals/14/Utpos ... _kompl.pdf
3. Sen disseminert sykdom, vanligvis etter mer enn 12 måneder.

Typisk hudmanifestasjon er acrodermatitis chronica
atrophicans. Ellers: Mere kroniske ledd- og muskelplager,
varierende nevrologiske sykdomsbilder (ofte
med fremtredende kognitiv svikt), sjelden kronisk hjertesykdom
(AV-blokk og kardiomyopatier). Okulær borreliose
med uveitt, retinitt, og annet forekommer både ved
tidlig og sen disseminert sykdom, men må regnes som
sjelden. Ved disseminert sykdom ser man ikke sjelden
forskjellige, sammensatte sykdomsbilder. Noen
ganger skyldes det at pasienten er infisert med
mer enn en genotype, andre ganger at pasienten
har en enkelt genotype som angriper
flere typer vev. Vår rutinediagnostikk
inkluderer ikke en slik kartlegging.
Translation (with google translate):
3. Late disseminated disease, usually after more than 12 months (this is a defintion that is more common in US).

Typical manifestations are acrodermatitis Chronica
atrophicans. Otherwise: More chronic joint and muscle pains,
fluctuating neurological disease images (often
with prominent cognitive impairment), rare chronic heart disease
(AV block and cardiomyopathies). ocular Lyme disease
with uveitis, retinitis, and others occur in both
early and late disseminated disease, but must be considered
rare. In disseminated disease, we see not infrequently
different, complex disease pictures
. some
times because the patient is infected with
more than one genotype, other times the patient
has a single genotype that attack
several types of tissue.
Our routine diagnostic
does not include such a mapping.

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Re: Info about European chronic (=late) Lyme

Post by X-member » Sat 17 Dec 2011 21:14

Some info from Denmark:

http://www.ugeskriftet.dk/portal/page/p ... vers1c.pdf
Acrodermatitis chronica atrophicans

ACA er den hyppigste form for kronisk borreliose (40,41,44,45). Der er skønnet over 50 tilfælde om året i Danmark. ACA kan udvikle sig efter et EM med en latenstid på 6 måneder til flere år og ses hyppigst hos ældre kvinder.
Translation (with google translate):
Acrodermatitis chronica atrophicans

ACA is the most common form of chronic Lyme disease (40,41,44,45). There are estimates of 50 cases a year in Denmark. ACA may develop after an EM with a latency of 6 months to several years and most commonly seen in older women.

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