Berlioz disease: how it manifests itself, the causes, description and characteristics of the treatment
Berlioz disease is an infectious disease transmitted through insect bites, in particular, ticks. It is caused by bacteria of the genus Borrelia, and depending on the continent their appearance may differ.
The study of
The first records of this disease appeared in 1975 in the United States. The first case was recorded in a small town of Lyme, in Connecticut. Hence the name. The reason for the beginning of the study was the treatment in the CDC( Center for Disease Control) of parents, whose children were diagnosed with "juvenile rheumatoid arthritis"( JRA).Later it was found out, that similar signs are and at several adults. So, by chance, was discovered Berlioz( Lyme disease).
The carrier of the pathogen of this pathological condition is a tick from the genus Iksodov. In their organism live and reproduce spirochetes of the genus Borrelia. When ingested after an insect bite, they spread through the circulatory system and pass the blood-brain barrier, getting into the cerebrospinal fluid and causing neurologic symptoms.
This rod of mites lives everywhere. Especially often it occurs in the Northern Hemisphere. But its species can vary, depending on the continent and part of the world.
There are several characteristics that determine the type and type of the clinical course of the disease. For each of them there is a corresponding branching.
- Forms: hidden( latent);manifest( open).
- Current: sharp;subacute;chronic.
- Symptom: bezearic;erythema.
- Area of damage: nervous system, skin, joints.
- The severity of the process: light, medium, heavy.
- Infection: seronegative;seropositive.
Each of these points is indicated in the clinical diagnosis and is reflected in the treatment and course of the disease. Therefore, it is important to determine what we are dealing with in order to be able to choose the right tactics.
Berlioz disease is caused by a bacterium from the spirochete genus - Borrelia burgdorferi. It is a gram-negative microorganism with flagella. It grows well on liquid nutrient media with a complex protein composition. In form, it looks like a twisted spiral, which slowly rotates. On its surface, the bacteria have antigens, which determine their specificity among subpopulations, and also provide a narrowly directed immune response.
About a dozen variants of this microorganism are already found, which are found in all corners of the globe. It has been clinically proven that the clinical picture of the disease depends on the serotype of the borreliia. Therefore, Lyme disease implies not one disease, but a whole group of homogeneous, but different in the etiology of nosology.
Pathogenetic pattern of
After a tick bite, its saliva enters the circulatory system, and at the site of penetration appears reddening in the form of a ring with a more diffuse inner edge and a sharper outer. The causative agent with blood flow spreads throughout the body, colonizing organs and tissues, penetrating into the lymph and spinal fluid.
The immune system begins to actively respond to the invasion by sending inflammation cells( macrophages, neutrophils) to the affected areas, producing cytokines, leukotrienes, prostaglandins and immunoglobulins of classes M and G. Borrelia perish, but when decomposed they release toxins that adversely affect the human body. In addition, the body, attacking infected tissues, destroys not only the pathogen, but also the cells of the body. In addition, in places where bacteria multiply actively, infiltrates from cells of inflammation and exudate are formed that disrupt the work of organs.
As the disease progresses, the number of immunoglobulins and immune complexes increases, cross-reacting antigens and antibodies appear on them. Substances that make up bacteria, provoke the production of inflammatory mediators in the joints, which destroy the hyaline cartilage and provoke the formation of pannus. This leads to clinical symptoms of the type of JRA.
After recovery, bacteria can persist in the body for up to ten years. Scientists can not yet find a reasonable explanation for this. A person develops non-sterile temporary immunity, and the disease can recur after a few years.
How does Berlioz appear? The disease first behaves quietly. The so-called incubation period must pass. It lasts up to two weeks, but possible and reactive options. Then the whole process is reduced to several days. Or, on the contrary, a slow flow, when the first symptoms can manifest themselves and a few years after the bite. The most common infection is from May to September, when mites actively feed on and multiply.
There are two periods of the disease: early and late.
The first stage of the early period can be acute or subacute. Characterized by general toxification symptoms, such as fever, fever, chills, muscle pain, headache, nausea, vomiting. Sometimes there are catarrhal symptoms - coughing, runny nose, a sore throat. On the site of the bite appears annular erythema. Patients say that in this place they feel burning, itching or even pain. Favorite localization of the insect is underarms, inguinal region and the scalp. Possible and allergic reactions to bite by the type of hives, conjunctivitis or rash.
A small percentage of patients may develop symptoms of irritation of the brain envelopes. They complain of nausea, vomiting, light and phobia, hypersensitivity, headache. They have increased intracranial pressure, but the cerebrospinal fluid can remain sterile.
The second stage occurs in every tenth patient. Usually it begins one month after infection. In this period, the inflammation of the brain membranes progresses, manifested by the symptoms of meningitis, meningoencephalitis with the defeat of the cranial nerves and peripheral nervous system. A characteristic feature is the bilateral paralysis of the facial nerve. A few months after the manifestation of the disease, patients develop complaints from the cardiovascular system. Violations of rhythm and cardiac conduction by the type of blockade are noted. Sometimes there is myocarditis or pericarditis, as a consequence of cross-reacting antigens.
A relatively small number of patients reach the third stage. How is Berlioz manifested? The disease lasts for more than six months and passes into a chronic course that is characterized by skin lesions, such as atrophic dermatitis, and joints. Neurological symptoms somewhat subside and become like a tertiary neurosyphilis. Patients complain of pain in the muscles and joints that have a non-permanent character.
Tick-borne borreliosis( Lyme disease) can also occur in pregnant women. During the antenatal period and childbirth no effect this pathological condition may not have, but there is a risk of intrauterine infection or the formation of congenital malformations of the heart muscle. It is known that the children of infected mothers died from hemorrhage into vital organs or were born dead.
By empirical observations it was revealed how many-sided Berlioz is a disease whose symptoms mimic for severe infections of the nervous system.
As usual, the doctor first conducts a survey of the patient, compares the data obtained from him with the time of year and the characteristic diseases for him. Inspects the patient for signs of an insect bite, ring-shaped erythema, or urticaria. Checks the neurological status, and also appoints an ECG.If it is suspected that this may be a tick borreliosis( Lyme disease), the description is recorded in the medical history, and the patient is asked to give blood for analysis and puncture fluid from the edge of the erythema to identify the pathogen.
Be sure to conduct a serological study to determine the type and type of borrelia, as well as determining the stage of the disease in a particular patient. The diagnostic titer for verification of the diagnosis is 1 to 64. Since at an early stage the study can give a false-negative result, it is recommended to repeat it in twenty days or a month, when the number of immunoglobulins will be longer and they will be enough to set the reaction. Possible and false positive reactions. They are found in patients with syphilis, infectious mononucleosis, recurrent typhoid, rheumatic diseases.
Distinguish the disease of berlioz with tick-borne encephalitis, erysipelas, and even cellulitis. This is the first stage. In the midst of the disease, rheumatic heart and joint damage, cardiomyopathy is at the forefront. By the third stage, Reiter's disease and neurosyphilis are added to this list.
It is extremely important to diagnose berlioz in time - a disease whose treatment can last for several months, or even years( due to non-sterile immunity).When the therapy is prescribed, the stage of the process, the etiology and the main pathogenetic manifestations are taken into account.
Antibiotic therapy should be present from the first stage, the earlier, the better. Then there is a chance that the disease will not have time to reach the organs and tissues, and therefore, it will be possible to avoid complications. Preparations for treatment are chosen such as "Tetracycline", "Doxycycline", "Amoxicillin" and others. They have a bacteriostatic effect on Borrelia, so you need to constantly maintain their concentration in the blood.
If, nevertheless, organ damage is detected, it is dangerous to prescribe tetracyclines, infectiologists recommend to stop their choice on penicillins or cephalosporins.
Simultaneously with antibiotics prescribe symptomatic and pathogenetic therapy to act on all links of the pathological chain. To do this, detoxify the patient's body, dehydration in order to relieve the increased intracranial pressure, physiotherapy procedures, in order to mitigate the manifestations of lesions of the cranial nerves and arthralgia. For anesthesia use NVPs or analgesics.
Often during treatment after a small light period, a sharp deterioration occurs. This is connected with the mass death of the spirochetes and their poisonous effect. Modern doctors are well aware that this is how borreliosis manifests itself. Symptoms and treatment of tick-borne borreliosis are referred to as sanitary enlightenment, since in this case the speed of the start of taking medications is important.
The nature of the forecast depends on how quickly a person realizes the problem and seeks medical help. Berlioz disease can be cured at an early stage and prevent its transition to chronization, but the causative agent in a small amount will still circulate in the body, like the formed immune complexes.
The dispensary observation is shown in the conditions of the KIZ( room for infectious diseases) for a year after clinical recovery. Patients are tested for a pathogen three weeks after discharge, then three months, six months and, finally, a year later.
Specific prophylaxis does not exist, but during the tick breeding season, it is recommended to wear long-sleeved clothes and trousers on the nature and use repellents in order to prevent bite. After a walk, you should check yourself and pets for the presence of ticks, as they are small enough, and their bites are almost painless.
Here is a brief overview of borreliosis, the causes, symptoms, treatment in an infectious hospital. Remember the danger of infection in the spring-summer period, and do not be afraid to go to the doctor.