tetracycline and Borrelia-Infections

Lyme disease has protean manifestations. The causative agent is Borrelia burgdorferi, a recently discovered spirochete. The disease has been found on three continents. The initial major clinical feature is a characteristic skin eruption known as erythema chronicum migrans. Subsequent main clinical manifestations are meningopolyneuritis and arthritis. However, clinical expressions of the disease vary widely. Some patients have very mild disease and others develop severe and prolonged illness. Specific laboratory tests for the detection of antibody to the organism are now available. The sensitivity of these tests approaches 100% when the sera are collected from patients having the later clinical manifestations. Penicillin and tetracycline are the therapeutic drugs of choice.

Topics: Adolescent; Adult; Aged; Arachnid Vectors; Arthritis; Aspartate Aminotransferases; Australia; Blood Sedimentation; Borrelia; Borrelia Infections; Child; Child, Preschool; Culture Media; Diagnosis, Differential; Disease Reservoirs; Erythema; Europe; Female; Humans; Immunoglobulin M; Lyme Disease; Lymphopenia; Male; Middle Aged; Nervous System Diseases; Penicillins; Tetracycline; Ticks; United States

A clinical trial was conducted in order to evaluate the efficacy of procaine penicillin and tetracycline, respectively, in the treatment of louse-borne relapsing fever. 184 patients (160 men, 24 women) admitted to the Gondar hospital during the rainy season 1992 were assigned to 1 of 4 treatment groups: procaine penicillin 100,000 (PP100), 200,000 (PP200) or 400,000 (PP400) international units (IU) intramuscularly (i.m.), or tetracycline 250 mg per os (TTC, p.o.). All drugs were given as single doses. The overall case fatality rate was 3.3%. Frequency of relapses, Jarisch-Herxheimer-like reactions (JHR) and deaths were significantly different between patients treated with TTC and those treated with PP100. Relapses occurred most often in the group receiving the lowest dose of penicillin (46%), and decreased with increasing dosage of penicillin; none of the patients treated with TTC had a relapse. Occurrence of JHR showed the opposite pattern: whilst 2 (5%) patients treated with PP100 developed a JHR, 16 (29%) in the PP200 group, 10 (31%) in the PP400 group, and 27 (47%) in the TTC group developed a JHR. As mortality is linked to severe JHR, and most relapses are clinically mild and easily treated, these results speak in favour of using low-dose penicillin to initiate the treatment of relapsing fever.

Topics: Adolescent; Adult; Animals; Blood Pressure; Borrelia Infections; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Fever; Humans; Insect Vectors; Male; Middle Aged; Penicillin G Procaine; Phthiraptera; Recurrence; Relapsing Fever; Tachycardia; Tetracycline; Treatment Outcome

We report a case of borreliosis mimicking uncomplicated malaria in a patient returning from Mali. Identification of spirochetes through examination of a thick blood smear completed by an acridine-orange quantitative buffy coat allowed the diagnosis of borreliosis. All symptoms rapidly resolved following tetracycline therapy. Epidemiological and clinical features of borreliosis, diagnostic tools and management are discussed.

Topics: Anti-Bacterial Agents; Borrelia Infections; Diagnosis, Differential; Fever; France; Humans; Malaria; Male; Mali; Middle Aged; Tetracycline; Travel

Four patients from Caribbean and Central American countries with ocular disease and serologic evidence of Lyme borreliosis are discussed. To our knowledge this is the first report of Lyme disease from this geographic area. Two patients exhibited ocular inflammatory disease, and two patients developed optic neuropathy. A brief discussion of Lyme borreliosis, its serologic diagnosis, and its treatment is presented.

Topics: Adult; Aged; Borrelia Infections; Ceftriaxone; Child; Endophthalmitis; Eye Diseases; Humans; Intraocular Pressure; Lyme Disease; Male; Middle Aged; Optic Nerve Diseases; Penicillins; Tetracycline; Visual Acuity; West Indies

The incidence of Lyme disease has been increasing at alarming rates in recent years. Being the most commonly reported tickborne bacterial disease in the United States, it now outnumbers Rocky Mountain spotted fever by a ratio of almost 2:1. It is a multisystem illness and can manifest itself with dermatologic, neurologic, cardiac and rheumatologic involvement. The ocular complications of Lyme disease can present as one of the more ominous signs during the course of the illness. The detection of the disease and proper referral by the optometrist may permit more appropriate treatment, and thus, a better prognosis of the illness.

Topics: Bites and Stings; Borrelia Infections; Conjunctivitis; Eye Diseases; Humans; Keratitis; Lyme Disease; Optic Nerve Diseases; Papilledema; Penicillins; Tetracycline; Uveitis

Topics: Adult; Biopsy; Borrelia Infections; Humans; Male; Skin; Skin Diseases, Infectious; Tetracycline

Topics: Borrelia Infections; Cefotaxime; Humans; Tetracycline

Topics: Adolescent; Borrelia Infections; Child; Humans; Tetracycline

We report on clinical and laboratory findings of 28 patients with tick-bite Borrelia burgdorferi-infection. In 5 cases chronic tertiary metaluetic manifestations were recognized. All were treated either with high-dose penicillin intravenously or tetracycline. Results of treatment and recommendations are given.

Topics: Acute Disease; Adult; Aged; Animals; Bites and Stings; Borrelia Infections; Chronic Disease; Female; Humans; Male; Middle Aged; Nervous System Diseases; Penicillin G; Tetracycline; Ticks

Between December 1978 and July 1985, we used various antibiotics for the treatment of 97 adult patients with early erythema migrans disease (EMD). Six patients with borrelial lymphocytoma (BL) and 20 with acrodermatitis chronica atrophicans (ACA) were treated similarly. Follow-up was for a median of 20, 14, and 12 months, respectively. The erythema migrans and all associated symptoms resolved within a median of 3 weeks (0.5-18.4), BL within 7 weeks (4-16), and ACA partly or completely within several months. A Jarisch-Herxheimer (-like) reaction was observed in 8 patients with EMD. Fourteen patients with EMD and one with ACA developed an exacerbation of symptoms or new manifestations between the 2nd and 20th day, and 28 patients with EMD and one with ACA continued to have or acquired various symptoms greater than or equal to 3 weeks after initiation of therapy. Arthralgia, neurologic and constitutional symptoms, and in one instance a slight pulmonary interstitial edema developed in EMD. More severe initial illness was a risk factor for the development of later symptoms in EMD. Retreatment was more often necessary in ACA than in EMD. A patient with ACA had a recurrence after 5 1/2 years. IgG antibody titers rose at least fourfold in 5 patients with ACA and in 1 with EMD despite therapy. We tentatively recommend minocycline or high doses of parenteral penicillin for the treatment of these disorders.

Topics: Acrodermatitis; Adult; Anti-Bacterial Agents; Borrelia Infections; Erythema; Erythromycin; Female; Follow-Up Studies; Humans; Male; Middle Aged; Minocycline; Penicillins; Tetracycline

Eight cases of meningoradiculitis (Garin-Bujadoux-Bannwarth's syndrome) are presented; the first case followed an "unidentified insect" bite and erythema chronicum migrans, whereas the second and third cases were not preceded by any documented insect bite or erythema; they occurred during summer in 1984 and 1985 and were characterized by cranial or radicular neuritis, lymphocytic meningitis, positive serology by immunofluorescence against Borrelia Burgdorferi and a good response to Penicillin (20 000 000 U during 14 days I.V.). Five other cases were observed in the same area as the first and second cases (Walloon Brabant) during the preceding summers; in two, serological proof of Borrelia Burgdorferi infection was obtained retrospectively. Lyme disease and Garin-Bujadoux-Bannwarth syndrome are both tick-born spirochetosis, due to two slightly different subtypes of Borrelia Burgdorferi. Their early neurological manifestations differ mainly by focalised pain on the bitten region in Garin-Bujadoux-Bannwarth's syndromes. This could be due to direct aggression of the peripheral nerve in Garin-Bujadoux-Bannwarth syndrome.

Topics: Antibodies, Bacterial; Arthropods; Bites and Stings; Borrelia; Borrelia Infections; Diagnosis, Differential; Female; Humans; Lyme Disease; Meningitis; Meningitis, Aseptic; Middle Aged; Penicillin G; Peripheral Nervous System Diseases; Radiculopathy; Tetracycline; Ticks

Topics: Adolescent; Adult; Aged; Arachnid Vectors; Borrelia Infections; Child; Female; Humans; Male; Middle Aged; Senegal; Tetracycline; Ticks

Two of 4 untreated vervet monkeys infected with Borrelia hermsii survived and were resistant to reinfection for at least 1 year. Seven of 9 vervets receiving tetracycline could be reinfected after 12 to 36 weeks. Immobilizine could be demonstrated for a shorter time in treated than in untreated vervets.

Topics: Animals; Antibodies, Bacterial; Borrelia Infections; Cercopithecus; Chlorocebus aethiops; Female; Haplorhini; Male; Monkey Diseases; Tetracycline; Time Factors

Topics: Animals; Anti-Bacterial Agents; Borrelia; Borrelia Infections; Chickens; Humans; Kanamycin; Lipopeptides; Peptides; Spirochaetales Infections; Tetracycline