Author/Editor		Strle, F; Nelson, JA; Ružić-Sabljić, E; Cimperman, J; Maraspin, V; Lotrič-Furlan, S; Cheng, Y; Picken, MM; Trenholme, GM; Picken, RN
Title		European Lyme borreliosis: 231 culture-confirmed cases involving patients with erythema migrans
Type		članek
Source		Clin Infect Dis
Vol. and No.		Letnik 23, št. 1
Publication year		1996
Volume		str. 61-5
Language		eng
Abstract		In 1994, we isolated Borrelia burgdorferi sensu lato from 231 patients with erythema migrans who presented to the University Medical Center in Ljubljana, Slovenia. Samples of erythema migransaffected skin were placed in media to support the growth of Borrelia species and evaluated in Ljubljana and Chicago. Patients whose cultures were positive included 132 women and 99 men; 136 of these 231 patients recalled a tick bite. Patients noted a rash an average of 24 days after a bite and presented a mean of 34 days after the bite with erythema migrans (mean diameter, 16 cm). Itching (44%), burning (18%), and pain (11%) were the most common local symptoms. Systemic complaints (40%) included headache, fatigue, malaise, and arthralgia. Other than erythema migrans, findings on physical examination were minimal (less th.5% had fever, and in less th.10% local lymph nodes were affected). Serial serological studies using indirect immunofluorescence assay, ELISA, and Western blot methods were performed, and antibodies to B. burgdorferi sensu lato were detected in less th.50% of samples from patients. This is the largest series reported to date of patients with culture-confirmed Lyme borreliosis. It highlights the deficiencies of serological tests in early disease, demonstrates the sensitivity of direct detection methods for evaluation of patients with erythema migrans, and suggests that patients with early Lyme borreliosis in Slovenia may suffer a milder illness than those in the Untied States.
Descriptors		ERYTHEMA CHRONICUM MIGRANS BORRELIA BURGDORFERI LYME DISEASE ANTIBODIES, BACTERIAL SKIN SERODIAGNOSIS SENSITIVITY AND SPECIFICITY BACTERIOLOGICAL TECHNIQUES BLOTTING, WESTERN ENZYME-LINKED IMMUNOSORBENT ASSAY FLUORESCENT ANTIBODY TECHNIQUE, INDIRECT AGE FACTORS