Author/Editor		Strle, Franc
Title		Klinični vidiki lymske borelioze
Translated title		Clinical features of Lyme borreliosis
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 39, št. Suppl 4
Publication year		2000
Volume		str. 115-18
Language		slo
Abstract		Lyme borreliosis is the most frequent tick-transmitted disease in Slovenia. When clinically completely expressed, tick bite is followed by a skin lesion, and later by heart, nervous system and joint involvement. Other tissues and organ systems may also be affected. Clinical signs depend partly on the species of the causative agent: Borrelia garinii is prone to affect the nervous system, B. afzelii is predominantly associated with skin affection, while B. burgdorferi sensu stricto, the only species causing the disease in America, is most commonly related with arthritis. The most frequent clinical sign of Lyme borreliosis is an enlarging skin lesion, named erythema migrans. It usually develops at the site of a tick bite, several days to weeks after the bite. Duration of an untreated skin lesion is a few weeks. Initially it is homogenous and later on ring-like as a consequence of central clearing. When typical, it enables a reliable clinical diagnosis and consequently rational treatment. The fact that laboratory confirmation of borrelial infection is as a rule required for a reliable diagnosis, and that some manifestations of Lyme borreliosis are at least partly a consequence of the immunological mechanisms, point to the necessity of close collaboration between microbiologists, immunologists and clinicians.
Summary		Lymska borelioza je med boleznimi, ki jih v Sloveniji prenašajo klopi, najpogostejša. Kadar je izražena v celoti, sledijo vbodu klopa kožne spremembe, tem prizadetost srca in živčevja, še kasneje lahko pride do prizadetosti sklepov. Poznane so tudi okvare oči, pozne nevrološke in kožne spremembe ter okvare drugih tkiv oziroma organov. Klinični znaki bolezni so delo- ma odvisni od vrste povzročitelja: Borrelia garinii največkrat povzroča okvare živčevja, B, afzelii okvare kože, B. burgdorferi sensu stricto, ki je edini povzročitelj lymske borelioze v Ameriki, pa okvare sklepov. Najbolj pogost klinični znak lymske borelioze je erythema migrans. Največkrat nastane na mestu vboda klopa: po nekaj dneh do tednih se pojavi rdečina, ki se postopno veča, začne na sredini bledeti in dobi obliko obroča, ki se še naprej širi navzven. Običajno traja nekaj tednov. V nasprotju z večino drugih bolezenskih znakov in simptomov omogoča dokaj trdno klinično diagnozo in s tem ustrezno zdravljenje. Dejstvo, da je za zanesljivo diagnozo lymske borelioze ob bolezenskih simptomih in znakih praviloma vedno treba dokazati borelijsko okužbo in da so zlasti pozno s potekom bolezni nekatere težave vsaj deloma odraz oziroma posledica imunskega dogajanja, nedvomno kaže, da je za učinkovito odkrivanje, dokazovanje in zdravljenje lymske borelioze nujno potrebno tesno sodelovanje mikrobiologov, imunologov in klinikov.
Descriptors		LYME DISEASE ERYTHEMA CHRONICUM MIGRANS PSEUDOLYMPHOMA ACRODERMATITIS NERVOUS SYSTEM DISEASES MUSCULOSKELETAL DISEASES HEART DISEASES EYE DISEASES