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

epresent a major health hazard and thus is of little consequence as a coinfection in
cases of Lyme disease.
Rickettsioses
To begin with, attention should be directed to the fact that the bartonellosis pathogen
belongs to the Rickettsia family.
In the USA the most important rickettsiosis is Rocky Mountain Spotted Fever
(RMSF), a potentially fatal, but normally curable disease. RMSF is the most frequent
rickettsiosis in the USA. The clinical picture is primarily characterized by high fever,
pronounced malaise, abdominal complaints, and a generalized exanthema.
Occasionally, the disease is also linked with CNS manifestations (focal neurological
deficits, cerebral seizures):
Worldwide, there are many different rickettsioses, which are caused by different
Rickettsia subspecies. The transmission generally occurs via ticks, but also via
mites, fleas, and lice. Generalized exanthema—the so-called localized eschar (black
wound)—as well as fever, headaches and severe muscle pains are typical symptoms
of the disease.
The most important rickettsiosis in Europe is the Mediterranean spotted fever;
pathogen: R. conorii. The disease primarily affects Southern Europe.
Treatment is performed with doxycycline.
Chronic courses have not been described in the literature. Differential diagnostic
problems in comparison to Lyme disease in the early stage should not result
because of the endemic circumstances and the presence of the exanthema.
For further information refer to the relevant medical literature.
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