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

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In Yersinia-PCR-positive patients, the serology was positive in 70% of the cases; the LTT in 50% [248]. In the initial detection of Yersinia enterocolitica using culture methods, IgA and IgG bands were found in immunoblot assay in patents experiencing a chronic course. The continuous detection of IgA antibodies was obviously an expression of a persistent infection; in this context the pathogens were detected in the intestinal mucosa and in lymphatic tissue. Hence, this was a definitely chronic, persistent Yersinia enterocolitica infection [258]. The antibiotic treatment of the Yersinia enterocolitica infection is presented in Table 18. Table 18 Antibiotic treatment of the Yersinia enterocolitica infection Antibiotic Dose / Day Ceftriaxone 2 g + Gentamycin 240 mg Ciprofloxacin 1000 mg Trimethoprim and sulfamethoxazole 875 / 125 2 x daily In accordance with test: Gentamycin 240 mg Doxycycline 400 mg Piperacillin 8 g Invanz 1 g Yersiniosis frequently abates within a few weeks so that an antibiotic treatment is not generally recommended. This also applies with regard to the excretors. Only in cases of severe disease courses, in particular with sepsis, are antibiotics used. Y. enterocolitica produces beta-lactamases with the consequence that penicillin, ampicillin and the cephalosporins of the first generation are ineffective [201, 205]. There is also frequently a resistance to macrolides. 32
It is also disputed whether early antibiotic treatment (i.e. for gastroenteritis) prevents reactive arthritis [203]. The differential diagnosis of chronic yersiniosis or chronic Lyme disease, respectively, is thus as a consequence of the many instances of overlap in the symptomology extremely difficult. In cases in which both diseases are present in their chronic form, a differentiation is often not possible at all. Mycoplasma pneumoniae infection The differential diagnostic differentiation between LD und Mycoplasma pneumoniae infection or the recognition of the coinfection by Mycoplasma pneumoniae is problematical because both diseases exhibit many identical disease manifestations; this applies to the extrapulmonary manifestation in Mycoplasma pneumoniae infections: disorders of the CNS, of the musculoskeletal system, of the heart, of the kidney and of the eye. The infection data and the symptomatology are given in Table 19. In the foreground is the atypical pneumonia, frequently linked to symptoms in the region of the upper respiratory tract. There is no data on the frequency of extrapulmonary manifestations in the literature. Table 19 Mycoplasma pneumoniae infection Infection data, symptomatology Pathogen: Mycoplasma pneumoniae Transmission: Droplet infection, humans Pulmonary symptomatology (and attendant symptoms): - (above all older people in nursing and old people’s homes are affected) 33
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 28 and 29: Late phase: - Reactive arthritis -
Page 30 and 31: the depiction of chronic yersiniosi
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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