Infectiologic differential diagnosis of chronic Lyme disease and so ...

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Late phase: - Reactive arthritis - Erythema nodosum - Arthralgias - Ankylosing spondylitis - Polyarthritis - Sacroiliitis - Iridocyclitis - Abdominal pains - Diarrhea - Ulcerative colitis - Neurological disease manifestations (central, peripheral) - Nephritis - Diabetes mellitus (insulin-dependent) - Hepatitis - (ANA positive) - (Rheumatoid factor positive) - Multisystem disease - Reduction of the overall survival time - (thyroiditis) - Pathogen detection in articular effusion - Pathogen detection in blood - Disease progresses in stages and intervals with fewer complaints - Correlation with thyroiditis - Positive LTT - Oscillating serological findings (correlation with disease expression) - (Erythema nodosum) - (Conjunctivitis) - (Gastrointestinal complaints) - (seldom: myocarditis) Articular manifestations: - Hip joints - Knee joints - Upper ankle joint - Sacroiliac joints Yersinia enterocolitica was already recognized as pathogen as early as the beginning of the 20th century. However, the true significance of the pathogen, in particular, under epidemiological aspects was first described in 1995 [146]. Acute illness due to Y. enterocolitica is subject to registration (according to German law). The pathogen penetrates into the intestinal wall and the mesenteric lymph nodes. Surface proteins and plasmid-bound virulence factors suppress the immune system of the host organism [147-150]. 28
The disease results primarily in gastroenteritis, pseudoappendicitis, und mesenteric lymphadenitis. In contrast to other bacterial gastroenteritides, the Yersinia enterocolitic gastroenteritis develops gradually and often becomes stressful or perceivable only after a week has passed [15 - 153]. Frequently, the infection is associated with a pharyngitis because the pathogens remain in the lymphatic tissue of the tonsils and the pharyngeal wall, where they can also be detected by means of a smear test. The concurrent occurrence of gastroenteritis with pharyngitis is typical for a yersiniosis [154]. The mean disease duration is approximately two to three weeks, but distinctly longer diseases courses have been described. The acute illness can be associated with numerous gastrointestinal complications, primarily as a consequence of a severe bacterial inflammation of the intestinal wall [155-157]. In addition, the disease can also affect many non-gastrointestinal organs [155, 156, 158 - 161]. The patients frequently remain excretory for months, even when the gastroenteritis has long since abated [152]. The yersiniosis can result in so-called reactive arthritis and is thus an important infectious disease in the differential diagnosis of Lyme disease. Since the disease can also sporadically occur [152] and frequently remains unrecognized, the anamnestic research for typical yersiniosis disease manifestations and data, particularly symptoms of the early phase is of considerable importance, particularly in the early phase. Differentiation between LD and yersiniosis is made even more difficult by the fact that both infections can cause a multisystem disease. For information on the individual disease manifestations see Table 16. The study by Saebo und Lassen [246], which determined many disease manifestations in a retrospective study of 458 patients, is of particular importance for 29
Page 1 and 2: Infectiologic differential diagnosi
Page 3 and 4: 3 Anamnistically, one has to consid
Page 5 and 6: Table 2 LD coinfections (not tick-b
Page 7 and 8: Table 5 Bartonellosis’ infection
Page 9 and 10: Table 6 Main disease manifestations
Page 11 and 12: 11 Fig. 1. Erythrocytes infected wi
Page 13 and 14: 13 Bartonellae are localized in ery
Page 15 and 16: ESR und CRP elevated Hypercalcemia
Page 18 and 19: Table 9 Antibiotic treatment of bar
Page 20 and 21: antibiosis is that the antibiotic i
Page 22 and 23: The laboratory diagnostics for Chla
Page 24 and 25: The arthritis occurs in 1% of the u
Page 26 and 27: In the differential diagnosis of Ly
Page 30 and 31: the depiction of chronic yersiniosi
Page 32 and 33: In Yersinia-PCR-positive patients,
Page 34 and 35: - Incubation period 3 weeks - Atypi
Page 36 and 37: system, of the skin and other organ
Page 38 and 39: - Ehrlichia chaffeensis [1] - Anapl
Page 40 and 41: Since seroprevalence merely express
Page 42 and 43: B. microti is the predominant patho
Page 44 and 45: epresent a major health hazard and
Page 46 and 47: The decisive diagnostic information
Page 48 and 49: Probable: IFA IgG 1:1024 and one of
Page 50 and 51: The main manifestation of the Campy
Page 52 and 53: The term “reactive arthritis” i
Page 54 and 55: In the diagnosis of a “reactive a
Page 56 and 57: Table 27 Disease manifestations of
Page 58 and 59: addition, other pathogens discussed
Page 60 and 61: [8] Schouls LM, Van De Pol I, Rijpk
Page 62 and 63: [25] Hermanowska-Szpakowicz T, Skot
Page 64 and 65: [43] Bakken JS, Krueth JK, Lund T,
Page 66 and 67: [60] Fox LM, Wingerter S, Ahmed A e
Page 68 and 69: [80] Marra CM. Neurologic complicat
Page 70 and 71: [100] Pulliainen AT, Dehio C. Barto
Page 72 and 73: [118] Bass JW, Freitas BC, Freitas
Page 74 and 75: [137] Gaydos CA, Roblin PM, Hammers
Page 76 and 77: [155] Cover TL, Aber RC. Yersinia e
Page 78 and 79:
multi-organ donors for the presence
Page 80 and 81:
[190] Straubinger RK, Straubinger A
Page 82 and 83:
[208] Bitnun A, Ford-Jones E, Blase
Page 84 and 85:
patients with reactive and undiffer
Page 86 and 87:
[242] Appelbaum PC, Gillespie SH, B
Page 88 and 89:
pneumoniae infection associated wit
Page 90 and 91:
[276] Thomas NH, Collins JE, Robb S
Page 92 and 93:
[294] File TM Jr, Segreti J, Dunbar
Page 94 and 95:
[310] Sorvillo FJ, Lieb LE, Waterma
Page 96 and 97:
henselae Isolates Collected from Ca
Page 98 and 99:
[345] Raoult D, Levy PY, Harlé JR,
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