Журнал инфектологии (Jul 2018)
Clinical and laboratory characteristics of diseases caused by Borrelia spp. in the inhabitants of the Novosibirsk region in 2015–2017
Abstract
The aim of the study was to establish the clinical and laboratory features of Lyme borreliosis (LB) and borreliosis caused by Borrelia miyamotoi in adults from Novosibirsk region.Materials and methods. The study included 724 patients, residents of the Novosibirsk region, hospitalized with a fever that arose after a tick bite in the epidemic seasons 2015–2017. In all patients, clinical manifestations of the disease, hemogram parameters and biochemical parameters of blood serum were studied. DNA of B. miyamotoi was detected in blood and cerebrospinal fluid (CSF) of patients using nested PCR; the results were confirmed by direct sequencing of PCR fragments. LB was diagnosed by the presence of erythema migrans as well as by the detection of Borrelia burgdorferi sensu lato DNA by PCR and/or specific IgM by ELISA. Results and discussion. B. miyamotoi DNA of the Asian type was identified in samples from 10,2% of 724 examined patients, LB with erythema migrans was diagnosed in 16,0% of patients, and LB without erythema migrans was revealed in 4,6% of patients. All patients with B. miyamotoi infection had high or moderate fever and symptoms of intoxication in the absence of erythema migrans; 13,5% of patients with B. miyamotoi had meningeal symptoms without any changes in the CSF. Notably, the changes in leukocyte formula were recorded more often in patients with B. miyamotoi compared to those with LB (p <0,05).In patients with B. miyamotoi infection, the increase in the activity of serum transaminases was poorly expressed, however their average values were higher than in patients with LB with erythema migrans (p <0,05).The conclusion. Nonspecific symptoms of the disease caused by B. miyamotoi have been established. These studies are the basis for inclusion the detection of B. miyamotoi DNA in blood samples using PCR into the complex of examination for patients with a fever after the tick bite.
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