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

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- Incubation period 3 weeks - Atypical pneumonia (3% - 10% of the cases.) - Bronchitis - Pharyngitis - Rhinitis - Earaches - Sinusitis Extrapulmonary manifestations: - Maculopapular exanthema - Vesicular dermatitis - Disorders in CNS (rare: � Encephalitis � Meningitis � Myelitis � Cranial neuropathy � Cerebellar ataxia Gastrointestinal symptoms: - Hepatitis - Pancreatitis Rheumatic symptoms: - Arthritis � Arthralgias � Myalgias � Polyarthritis Cardiac symptoms: - Cardiac arrhythmias - Atrioventricular blockMyocarditis Glumerulonephritis Uveitis Mycoplasma pneumoniae is considered to be the most important pathogen of atypical pneumonia. However, pneumonia only occurs in approximately 3% - 10% of the cases in Mycoplasma pneumoniae infections [204]. In most cases, the infection results in a banal bronchitis [204], pharyngitis, rhinitis, ear aches, and sinusitis [205]. All the extrapulmonary disease manifestations listed in Table 17 are seldom [206 - 214]. In arthritis, Mycoplasma pneumoniae was detected in the synovial fluid by means of PCR [211]; this is an indication of a direct relationship to the infection. 34
Pathogen detection in articular effusion and the many extrapulmonary disease manifestations document the chronic disease course in cases of Mycoplasma pneumoniae. However, precise data on the chronic disease course are not available in the literature In particular, whether a chronic infection, especially with extrapulmonary disease manifestation, can persist with seronegativity is unclear. Seropositivity documents the infection, but it principally cannot serve as a diagnosis basis for a chronic persistent Mycoplasma pneumoniae infection. The literature on the relationship between Mycoplasma pneumoniae and neurological disease manifestations is comparatively extensive. The publications primarily refer to neurological complications in pneumonia, i.e. the early phase of the Mycoplasma pneumoniae infection. The neurological manifestations involve both the early phase, i.e. the point in time of existing pneumonia due to Mycoplasma pneumoniae, and later disease stages. Changes in the region of the brain stem [259, 267], myelitis [260, 263, 265, 269, 271, 274, 277, 279, 281, 284, 286], Guillain-Barré syndrome [261, 262, 268, 272, 282, 283], encephalitis [270, 273, 275, 276, 278, 280, 281, 285, 286], meningitis [270], polyradiculopathy [263], peripheral facial paresis [264, 266], optical neuritis and hemorrhagic leukoencephalitis [268], peripheral polyneuropathy [270], disorders of the brain nerves [282], radiculitis [282] have been described. The frequency of neurological symptoms in connection with Mycoplasma pneumoniae varies between 1‰ [287], 1% [288], and 5% [289]. The pathogen has been repeatedly detected by means of culture methods or PCR [270, 274, 283]. Pathogen detection in serum and liquor is considered to be proof that the neurological manifestations are mediated infectiously and not immunologically [283]. However, the connection between Mp and neurological manifestations is not undisputed [290, 287]. Other extrapulmonary manifestations mentioned in the literature involve hepatitis, hemolytic anemia, Schönlein-Henoch purpura, disorders of the muscular-skeletal 35
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 32 and 33: In Yersinia-PCR-positive patients,
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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