Key characteristics of tick-borne borreliosis, treatment methods. Determination of symptoms and treatment of tick-borne borreliosis

Borreliosis mite, as it is often called, is a pathogen. The disease was first recorded in the seventies of the last century in the American city of Lyme, where the name came from. Later, tick-borne borreliosis was discovered in other European countries, including Russia. Every year, about 8 thousand cases of this disease are recorded in the country.

On a note!
It is impossible to become infected with borreliosis without a tick bite, which has been scientifically proven. Some doctors believe that the disease is sexually transmitted due to the fact that semen contains Borrelia, through the blood of a donor and unpasteurized milk of an infected animal. All these assumptions are questionable. If there is such a possibility of infection, it is negligible.

Classification of the disease

The causative agent of borreliosis penetrates cells and can remain there, without showing itself, for a long period (up to 10 years) in the so-called “dormant state”. This leads to chronic borreliosis. The patient is not dangerous to others and cannot infect other people. The disease is classified according to different signs. Its form is:

Latent. Conducted laboratory analysis shows the absence of symptoms.
Manifest. The patient is experiencing rapid development of infection.

The course of the disease can take acute form, which is divided into the following types:

Erythema. If you are bitten by a Borreliosis mite, redness is observed in this area, which increases in size over time.
Non-erythematous. There is no redness at the site of the bite. Damage occurs to the nervous and cardiovascular systems and joints.

On a note!
The acute course of borreliosis from a tick bite lasts for 3 months, and the subacute course from 3 to 6.

The chronic form of the course is of two types:

Continuous.
Recurrent. There is a recurrent disease in which damage to the skin, heart, joints, and nervous system occurs.

According to the severity of borreliosis, there are 4 forms:

light;
moderate severity;
heavy;
extremely heavy.

The nature of Lyme disease is natural focal. There are 3 types of Borelli:
burgdorferi;
garinii;
afzelii.

They are microscopic microorganisms whose length is from 11 to 25 microns. The first signs of borreliosis after a tick bite in a person begin to appear after 1-2 weeks. The incidence is detected on all continents. The only exceptions are the Arctic and Antarctic. The hosts of the pathogen can be a variety of animals: sheep, dogs, rodents, large cattle. They do not pose a danger to humans, unlike an infected tick, which transmits the infection to the next generation. Most often they are found in regions with a temperate climate, especially in those areas where there are many mixed forests. In Russia these are the central regions, Western Siberia and the Urals. observed with the arrival of spring.
The bite of a borreliosis tick can cause 2 types of diseases: borroleosis and. This various diseases, they differ in incubation period, symptoms, treatment. Tick activity continues until October. At this time, they can bite any person, regardless of age. People suffer the most severe borroleosis old age and children. The likelihood of getting sick increases when visiting parks and forest areas.

Stages and symptoms of the disease
For a person, the development of the disease can go unnoticed, especially if he has not felt it. There are 3 stages of the disease, which are characterized by certain symptoms and consequences tick-borne borreliosis.
Stage I
It is characterized by local and general manifestations. They are reversible and last from 30 to 40 days. The first signs begin to appear 3 days after the tick bite. Some people (6-8% of total number sick patients) do not experience any symptoms at all - a hidden course of the disease. Most people experience redness in the area of the bite in the form of a spot, which increases in size every day. Most often, spots appear on the legs, chest, shoulders, neck, and groin area. Sometimes the spots appear to “creep” all over the body; they are not connected to the site of the bite in any way. Symptoms of Lyme disease at this stage include:
headache;
dizziness;
general malaise, which manifests itself in weakness, chills.
nausea and vomiting (in rare cases);
pain and tension in the neck muscles and joints;
photophobia.

Some patients appear specific signs in the form of a runny nose, coughing, sore throat.
In a certain proportion of people, the manifestation of the disease after a tick bite can only appear in the form of spots. If measures are not taken and borreliosis is not treated in time, it can develop into other stages. The majority of infected people proper treatment recover and acquire immunity for 5 years.

Stage II
The infection at this stage spreads throughout the body and lasts about three months. The disease is chronic. Borrelia penetrate deep into the tissues and cells of the body, damaging the brain and spinal cord, joints, heart, and retina. This stage is characterized severe course diseases. Symptoms of borreliosis after a bite are as follows:
damage to the nervous system is observed, the heart suffers, brain activity is disrupted;
strong headache pulsating in nature, appear painful sensations in the back area, memory and sleep are disrupted, symptoms of facial paralysis appear;
10% of patients experience heart failure, shortness of breath, stiffness of movement, chest pain, uncharacteristic heartbeat, and diseases such as pericarditis and myocarditis.

To prevent further development disease, it is necessary to carry out appropriate treatment for tick-borne borreliosis; the disease can drag on for several months, sometimes up to two years.
Stage III
At this stage, borreliosis acquires acute course. It manifests itself in the form of chronic arthritis, atrophic acrodermatitis (severe damage to the skin), disorders of the nervous system (encephalopathy, polyneuropathy, encephalomyelitis). Most often, the disease affects one system.
At this stage, a person needs long-term. The consequences in adults can be very different. Recovery is not always possible. Not everyone can survive this stage of the disease normally. A large number of patients are doomed to relapse. This leads to disability and job loss. Rare, but possible death.

How to treat borreliosis
Prevention of borreliosis is not carried out. A patient who has been bitten by a tick is constantly monitored. If a virus is detected in a person’s blood, the doctor immediately prescribes the necessary therapeutic treatment with the help of antibiotics, supplementing the course with vitamins.
Any disease, including ixodic tick-borne borreliosis, begins to be treated with an examination by a doctor, who must make the correct diagnosis. He examines the patient’s body for the presence of red spots, writes a referral letter, and schedules a consultation with an infectious disease specialist and a dermatologist. A clinical blood test will help identify specific antibodies to the pathogen. It is recommended to do it twice, with an interval of 2-3 weeks, for a clearer picture of the disease.
Medicines are prescribed by the attending physician. He also describes the regimen and dosage of medications, taking into account the stage of the disease and its reaction to the body.
In no case should you self-medicate, as the risk of an unfavorable course of the disease may increase.

The drug Tetracycline gives a good effect at the initial stage. It is taken 500 mg 4 times a day. It is sold in pharmacies, the cost of the drug is reasonable, on average it is 120 rubles.
In the acute stage, they are prescribed medicines general action. These include:
Cefuroxime;
Amoxicillin;
Azithromycin, etc.

Lyme disease often involves taking different medications. Their combination gives best effect. Also, when prescribing, the doctor takes into account the presence different types symptom. So when neurological manifestations The following drugs have proven themselves to be effective:
Doxycycline. It should be taken 2 times a day.
Ceftriaxone. This medicine is administered intravenously at 2000 mg once a day.
Levomycetin. It is taken orally or administered intravenously 4 times a day, 500 mg.

The course of treatment for any of them is designed for 14-28 days.
If a person is diagnosed with Lyme disease, he must adhere to a proper diet. The diet should include foods that normalize the functioning of the gastrointestinal tract. In the morning and evening, it is recommended to consume real yogurt or kefir, which helps remove toxins from the body. You need to drink juices (made yourself from fresh fruits and vegetables) and purified water. If neurological symptoms appear, you should eat chicken and fatty fish. For salad dressings, it is advisable to use pumpkin and flaxseed oil.
These will help in treatment folk remedies:
White clay. It is sold in pharmacies. You need to drink it for six months, after which you can take a break. In 250 ml clean water dilute 1 tsp. clay, leave it overnight and drink the settled water in the morning before eating. This drink removes toxins from the body.
Powdered seaweed. One sachet is taken for 10 days, then a break of 10 days is taken. And this should be taken for 5 months. This tool cleanses well the lymph, blood and gastrointestinal tract.
Infusions of tansy, wormwood, nettle, rose hips, calendula, linden flowers, hawthorn. Infusions and decoctions are made from these plants and applied to the stains. They go away faster and don't itch.

Emergency prevention consists of. For this purpose, iodine, brilliant green and celandine juice are used. Oil helps a lot walnut, plantain juice. When going for a walk in a park or forest, you must have one of the listed products in your first aid kit.
Lyme disease in children
Children preschool age practically do not suffer from borreliosis. The consequences for a child after a tick bite can be unpredictable. The main danger is the development of meningitis. After a course of treatment, children may exhibit residual reactions in the form of increased excitability, unstable mood, and sleep disorders. After a certain period of time they completely disappear. and the course of the disease is the same as in adults. If a child is bitten by a tick infected with borreliosis, and the first signs of the disease begin to appear: it worsens general state If redness appears at the site of the tick bite, you should immediately consult a doctor.
Olga, Irkutsk

Prevention
Prevention of borreliosis after a tick bite also involves taking the following antibiotics: Doxycycline, Ceftriaxone. The dosage and regimen should be prescribed by a doctor.
Most the best prevention after a tick bite it will become timely.

This disease (syn. Lyme disease) is a natural focal chronic infection. Tick-borne Borrelia is caused by one of the species Treponema – Borrelia Burgdorfer. How the disease manifests itself, how to identify it and treat the disease, find out below in the article.

Symptoms of different stages of tick-borne borreliosis

There are 3 stages of the disease. The signs of each of them have their own specifics.

Symptoms of stage I of tick-borne borreliosis

Stage I lasts up to 40 days and is characterized by the development at the site of introduction of the pathogen of primary affect in the form of chronic migratory erythema of Afzelius-Lipschütz. The main symptom of the disease at this stage is a single (sometimes several) rounded red spot at the site of the bite, which over the course of several weeks, gradually growing centrifugally, reaches 15–20 cm or more in diameter.

As the erythema grows with tick-borne borreliosis, its central part undergoes regression; in its zone a mark (in the form of a reddish dot) from a tick bite can be clearly visible. The edge of the erythema is represented by a narrow erythematous strip (width from several millimeters to 1–2 cm). Most often, the focus of borreliosis is localized on the torso, limbs, but can also be on the face.

As it grows, the marginal border of the erythema can rupture, turning into a garland-like strip that sometimes passes through the chest, neck, and face of the patient. Subjective symptoms are usually absent. Erythema is a marker sign of the disease, but in 30–60% of cases it may be absent. In addition to adult ticks, a person can be attacked by much smaller young individuals, which attach painlessly, and the fact of the bite may not be noted.

Symptoms of tick-borne borreliosis at stage II

Stage II of the disease, caused by lympho- and hematogenous dissemination of the pathogen and developing from the 3rd to the 21st week of the disease (usually in the 4th–5th week), is characterized by the following symptoms of tick-borne borreliosis:

damage to the nervous system with the development of serous meningitis,

neuritis cranial nerves,

radiculoneuritis,

cardiovascular system with the development of myocarditis,

pericarditis,

conduction disorders (especially atrioventricular block).

Often, with tick-borne borreliosis, a flu-like syndrome occurs (headache, fever, weakness, myalgia). Skin lesions in this stage of the disease borreliosis can be in the form of secondary ring-shaped elements with a diameter of 1–5 cm, an erythematous rash on the palms of the type of capillaritis, urticarial rashes, as well as benign lymphocytoma of the skin of Spiegler in the form of a single infiltrate - a nodule or disseminated plaques, most often on the earlobes, nipples and areolas of the mammary glands, swollen, bright crimson in color, slightly painful on palpation.

Signs of tick-borne borreliosis at stage III

In stage III of tick-borne borreliosis, late, developing more often a year after infection and lasting from several months to 10 years or more, persistence of the pathogen is often noted in any organ, damage to the musculoskeletal system is observed - monoarthritis (mostly of the knee joints) or polyarthritis , chronic encephalitis, encephalomyelitis. Develop on the skin

acrodermatitis atrophic chronic,
spotty atrophy,
scleroderma-like changes.

Histologically, borreliosis reveals microangiopathy, lymphocytic infiltration of the skin with an admixture of plasma cells.

There are also possible cases of congenital tick-borne borreliosis with heart defects.

Diagnosis is based on clinical and serological data. The causative agent of borreliosis can be isolated from the affected skin, cerebrospinal fluid, blood, synovial fluid, for which the material is inoculated and cultured. The most informative RIF in diagnosing the disease is the detection of antibodies to the pathogen in the blood and cerebrospinal fluid, which gives a positive result in 60% of cases in stage I of the disease and in 100% in stages II and III. Differential diagnosis carried out with various types erythema, scleroderma.

Symptoms and diagnosis of neuroborreliosis

The disease is a manifestation of Lyme disease. The causative agent of this form of the disease is Borrelia, which belongs to the genus of spirochetes. Infection occurs transmissibly through the bites of ixodid ticks.

Clinical manifestations neurogenic borreliosis occur against the background of general clinical symptoms of neuroborreliosis, characteristic of borreliosis infection.

Characteristic symptoms of neuroborreliosis are ring-shaped erythema at the site of the bite, damage to the joints and nervous system. The appearance of headache, photophobia, hyperacusis, hyperesthesia skin, vomiting, obvious signs meningeal syndrome, focal symptoms indicate the development of meningitis or meningoencephalitis. Most often, 3-4 pairs are exposed to pathogenic effects of Borrelia, less often - 9-12 pairs.

Another typical symptom complex of neuroborreliosis is Bannwart's lymphocytic meningopolyradiculoneuritis. A characteristic manifestation is pain syndrome, associated with the site of tick suction and resulting from involvement of the spinal nerve roots in any part of the spine, more often in the cervicothoracic. Characteristic signs of irritation and loss of functions of sensory and motor roots. Liquorological changes in Bannwart syndrome are characterized by moderate lymphocytic pleocytosis and moderate protein content.

The etiological diagnosis of neurogenic borreliosis is based on serological tests with paired sera. The most promising methods are molecular genetic diagnostics.

Features of the treatment of tick-borne borreliosis

The general principles of therapy are as follows: Penicillin - 2,000,000 units or more per day for 2-3 weeks (depending on the stage), Tetracycline - 1,000,000-2,000,000 units per day, Amoxicillin - 1,000,000- 2,000,000 units per day (children 20–40 mg/kg per day).

For the treatment of tick-borne borreliosis, Erythromycin is also used at a dose of 1,000,000 units per day (for children 30 mg/kg per day). For damage to the nervous system and arthritis, Penicillin G and Ceftriaxone are used.

Etiotropic therapy of tick-borne borreliosis

Treatment includes a complex therapeutic measures, in which the leading role is given to etiotropic therapy for the treatment of borreliosis. Medicines are prescribed orally or parenterally depending on the clinical picture and period of the disease. From oral medications preference is given tetracycline antibiotics .

The drugs are prescribed in the first period of the disease in the presence of erythema at the site of tick bite, fever and symptoms of general intoxication, provided there are no signs of damage to the nervous system, heart, or joints. Tetracycline 0.5 g 4 times a day or Doxycycline (Vibramycin) 0.1 g 2 times a day are prescribed for the treatment of tick-borne borreliosis, the course of treatment is 10 days.

Children under 8 years of age are prescribed Amoxicillin (Amoxil, Flemoxin) orally 30–40 mg/kg per day in 3 doses or parenterally 50–100 mg/kg per day in 4 injections. Cannot be reduced single dose drug and reduce the frequency of drug administration, since to obtain a therapeutic effect it is necessary to constantly maintain a sufficient bacteriostatic concentration of the antibiotic in the patient’s body.

Neurological treatment for borreliosis

If damage to the nervous system, heart, or joints is detected in patients (in patients with acute and subacute course), it is not advisable to prescribe tetracycline drugs, since some patients experienced relapses after the course of treatment, late complications, the disease became chronic. When identifying neurological, cardiac and articular lesions, Penicillin or Ceftriaxone is usually used. In contrast to the recommended penicillin therapy regimens, we have specified the single dose of the drug, the frequency of its administration and the duration of the course of treatment. Benzylpenicillin (penicillin G) is prescribed at 500 thousand. ED intramuscularly 8 times a day (with an interval of strictly 3 hours). The duration of the course is 14 days.

Patients with clinical symptoms for the treatment of tick-borne borreliosis in the form of meningitis (menigoencephalitis), a single dose of Penicillin is increased to 2–3 million units depending on body weight and reduced to 500 thousand. ED after normalization of cerebrospinal fluid. Repeated administration of Penicillin maintains a constant bactericidal concentration in the blood and affected tissues. A similar scheme of penicillin therapy has been tested and successfully used in the treatment of syphilis, the pathogenesis of which is in many ways similar to the pathogenesis of Lyme disease. Thus, there is a similar mechanism of early damage to the central nervous system in these infections, common features immunological processes and the similarity of the pathogens of both infections.

Currently the most effective drug for the treatment of tick-borne borreliosis is Ceftriaxone (Longacef, Rocephin) in daily dose 1–2g. Course duration is 14–21 days.

Treatment of chronic tick-borne borreliosis

In case of a chronic course of the disease, the course of treatment with penicillin according to the same regimen lasts 28 days. The use of antibiotics seems promising penicillin series prolonged action – extensillin (retarpen) in single doses of 2.4 million units once a week for 3 weeks.

In the chronic course of the disease with isolated skin lesions, positive results can be obtained from treatment with tetracycline antibiotics.

In cases of mixed infection (Lyme disease and tick-borne encephalitis) along with antibiotics, anti-tick gamma globulin is used.

Preventive therapy for tick-borne borreliosis

Preventive (preventative after a bite) treatment of borreliosis victims of a tick bite infected with Borrelia (the intestinal contents and hemolymph of the tick are examined using dark-field microscopy) are treated with Tetracycline 0.5 g 4 times a day for 5 days or Bicillin-3 - 1 million 200 thousand - 2 million 400 thousand. ED intramuscularly once. Also for these purposes, the Department of Infectious Diseases of the Military Medical Academy with good results uses Retarpen (Extencillin) at a dose of 2.4 million units intramuscularly once, Doxycycline 0.1 g 2 times a day for 10 days, Amoxiclav 0.375 g 4 times a day for 5 days. Treatment of borreliosis is carried out no later than the 5th day from the moment of the bite. The risk of developing the disease is reduced by up to 80%.

Pathogenetic treatment of the disease

Along with antibiotic therapy, pathogenetic treatment of tick-borne borreliosis is used. It depends on the severity of the disease. So:

in case of high fever, severe intoxication, detoxification solutions are prescribed parenterally,

for meningitis - dehydration agents,

for neuritis of the cranial and peripheral nerves, arthralgia and arthritis - physiotherapeutic treatment.

Patients with signs of heart damage are prescribed Panangin or Asparkam 0.5 g 3 times a day, Riboxin 0.2 g 4 times a day.

In cases of immunodeficiency, Timalin is prescribed for the treatment of tick-borne borreliosis at 10–30 mg per day for 10–15 days.

In patients with symptoms of autoimmune manifestations, for example, often recurrent arthritis, Delagil is prescribed 0.25 g once a day in combination with non-steroidal anti-inflammatory drugs (Indomethacin, Metindol, Brufen, etc.). The course of treatment for borreliosis is 1–2 months.

Prognosis for recovery from tick-borne borreliosis

The prognosis is favorable. With late or inadequate etiotropic therapy, the disease progresses, often becoming recurrent and chronic. Decreased ability to work and, in some cases, disability are caused by persistent residual symptoms of tick-borne borreliosis. Those who have recovered from the disease are subject to dynamic medical observation for a year (examination by an infectious disease specialist, therapist, neurologist, staging indirect reaction immunofluorescence every 3 months), after which a conclusion is made about the absence or chronicity of infection.

How is tick-borne borreliosis transmitted?

The carriers of the causative agent of tick-borne borreliosis are ixodid ticks, which are widespread in wooded areas of the temperate climate zone. The area of the disease is close to the area of tick-borne encephalitis. Ticks retain the pathogen for life and can transmit it to offspring. Sources of infection for borreliosis are mouse-like rodents (voles, small hamsters) - feeders of the preimago - the early phase of tick development, large ungulates (elk, deer, farm animals) - feeders of the imago.

The main route of transmission of tick-borne borreliosis to humans is transmissible - specific inoculation with the saliva of an infected tick. The seasonality of borreliosis is pronounced with an increase in the number of cases in the spring-summer and summer-autumn periods. Incubation period tick-borne borreliosis ranges from 3 days to 3 months (on average 3 weeks).

The acute form of borreliosis, which occurs in the form of erythema on the skin, has a mild course and is 90% curable, and does not leave any complications. If these early symptoms of the disease go unnoticed and if left untreated, Lyme disease can become chronic, which can persist for many years, remain hidden and cause no symptoms.

However, at some point the disease may suddenly begin to attack again, but not the skin, but the heart or central nervous system. This type of borreliosis can leave behind very serious complications.

Consequences of borreliosis

If the bacterium is not killed when the disease spreads only to the skin, it can penetrate through the blood or lymph into almost all organs of our body. This is why treatment of borreliosis in the early stages of infection is so important. Of course, it takes a while before the bacteria reaches the brain or heart—this could be weeks, months, or even years.

Late symptoms of borreliosis are not very characteristic, and, moreover, develop long after infection, which creates additional difficulties for diagnosing Lyme disease. Sometimes, before a pathogen is detected, e.g. Borrelii the disease can progress greatly, and its consequences become irreversible.

Brain complications of borreliosis

The most serious complications arise if the disease affects the central nervous system. Disease in the nervous system can occur in the form of soft shape inflammation meninges, and sometimes may also involve involvement of cranial or peripheral nerves. However, properly treated neuroborreliosis does not leave behind long-term complications.

Erythema migrans...

Consequence inflammation facial nerve it may be damaged, which is associated with paresis of the nerves of this side of the face. As a result of the lesion, the appearance of the patient's face changes - the corner of the mouth droops, the skin between the nose and cheek and the skin of the forehead smoothes out. Such a patient is unable to bare his teeth or move his cheeks.

Regurgitation of the eyelids may also occur, leading to dryness. eyeball, and, in addition, it becomes more susceptible to infections. With neuroborreliosis associated with inflammation of the peripheral nerves, complications may develop in the form of colic in specific parts of the body, severe neuropain, or fatigue of the arms or legs.

The most dangerous form of neuroborreliosis is chronic inflammation of the brain. After such an illness, paralysis of all muscles may occur, not only the limbs or torso, but also the sphincters. This can cause permanent damage to the cranial nerves.

Inflammation of the brain as a result of infection with borreliosis can also lead to changes in the human psyche. They may develop psychosis, dementia, problems with concentration and attention. There are also depressions, the cause of which is most likely inflammation of the brain.

Bacterial brain disease can also lead to the formation of areas of ischemia in the brain, which can affect brain function and body function in various ways. It happens that weakening or impairment of hearing and vision occurs.

Cardiac complications of Lyme disease

Chronic bacterial infection Borrelii may cause heart problems. The disease affects the heart muscle and also causes endocarditis and pericarditis. This can lead to disturbances in the functioning of the heart and, in particular, disturbances in the conduction of nerve impulses that are responsible for the proper contraction of the heart muscle.

Rhythm disturbances can be very dangerous to human health and even life. The patient feels an uneven heartbeat. As a rule, heart problems disappear within 6 weeks, but in 5% of people there may be irreversible consequences in the form of heart failure.

Joint complications after Lyme disease

Sometimes, although rarely, Lyme disease leaves permanent consequences in the form of joint inflammation. Pain may appear simultaneously with skin changes or even two years after infection with the bacterium. Typically the knees are affected.

The disease progresses spasmodically - asymptomatic periods alternate with periods of exacerbations. As a rule, arthritis goes away after antibiotic therapy and does not leave long-term consequences. However, if treatment is not implemented at the right time, it can lead to joint deformation.

Unfortunately, Lyme disease, if it does not manifest itself with skin changes, becomes very difficult to diagnose, due to the fact that the internal forms of this disease have completely uncharacteristic symptoms.

Often the key to staying healthy and alive is self-examination at the time of a potential tick attack. However, if this does not happen, symptoms of organ damage may appear many years after the bite and are difficult to associate with borreliosis. In such a situation, the main thing is the doctor’s intuition and experience.

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There is an unpleasant disease that has a beautiful name: Lyme disease, or ixodid tick-borne borreliosis. The disease is caused by Borrelia Burgdoffer.

Abundance beautiful words, with a small correction: Lyme is capitalized because it is not a fruit, but the name of a city in America where a cluster case of inflammatory joint damage associated with a tick bite was described. Well, the causative agent is a spirochete, a close relative of the causative agent of syphilis.

The trouble with Lyme disease is that it can last a lifetime, but good news is that it extremely rarely causes death.

A feature of this infection is very widespread damage to organs and systems. Perhaps this is the most “omnivorous” of all infectious diseases transmitted by ticks. But first things first.

Tick-borne borreliosis (Lyme disease) - what is it?

Dry scientific definition states that borreliosis is a microbial infection of a naturally focal, transmissible nature, which is caused by Borrelia, a spirochete. The disease affects the nervous system, skin, heart and musculoskeletal system. The disease is prone to chronicity and slow progression.

Although tick-borne encephalitis and borreliosis are equally transmitted by ticks, encephalitis began to be studied back in the 30s of the twentieth century, and Lyme disease was first included in the list of diseases in Russia only in 1992.

This disease is “fresh”: intensive study of it began precisely thanks to the outbreak in Lyme, and the peak of study occurred in the 80-90s.

The causative agent of tick-borne borreliosis is a mobile, elegant little spiral, related to the causative agent of syphilis. It was first isolated by Burgdofer in 1982, during the unfortunate Lyme outbreak. At first it was thought that only one type of microbe caused the disease, but now this “family” includes more than 30 types of Borrelia.

The microorganism is unstable and quickly dies in external environment, as well as under the influence of disinfectants. How is it transmitted to humans?

Epidemiology

It is important to know that only where ticks attack people do encephalitis and borreliosis occur. This is the natural focality of the lesion. Ticks are found where there are forests: in the Urals, Siberia, and the Far East. If we distribute the incidence throughout the country, then 6 people per 100 thousand people fall ill per year.

IN wildlife There are carriers of Borrelia, these are small rodents, deer, and birds. It is ticks that transmit the pathogen to humans, and almost everyone gets sick with borreliosis, that is, there is a high susceptibility to it.

The main thing is that the patient is completely harmless to others and cannot infect anyone. In nature, from 10 to 60% of ticks are “infected” with borreliosis, and average incidence – 1 case per 20 tick bites.

Naturally, the peak incidence occurs in summer - autumn, and those who get sick mainly are those who walk through the forest, that is, middle-aged men.

Tick-borne borreliosis photo signs on the skin

Despite the fact that borreliosis flows in phases, in the first stage, as a response to the penetration of the pathogen, an inflammatory and allergic reaction develops, which is called ring-shaped migratory erythema.

In this case, the patient’s condition does not suffer particularly, since the body’s immune response is very slow.

This primary stage lasts up to a month. Its classic signs are:

Ring-shaped migratory erythema - at the site of the tick bite, redness appears, with a gradual expansion of the zone, which is surrounded by a cushion. It can increase from 3 to 40 cm. This sign is pathognomonic, since it is 100% likely to indicate the presence of Lyme disease. In the center, the erythema gradually fades, becoming cyanotic;
Pain and itching of the skin occur in the area of erythema;
In most cases, in the erythema zone there are signs of lymphadenitis: the nodes are painful when touched, enlarged;
There may be a slight increase in temperature, muscle pain and malaise.

After the first stage, in which sensitization of the body occurs, the erythema spontaneously disappears after 15-20 days. Next, a detailed picture of the disease emerges.

In some cases, with good immunity, the symptoms of tick-borne borreliosis end there and recovery occurs. With weak immunity and large quantities pathogen, generalization of the process occurs.

Since so many organs are involved, they distinguish special groups Symptoms of Lyme disease:

Neurological manifestations;
Cardiac or cardiac disorders;
Articular manifestations.

Neurological symptoms

Most often occur serous meningitis, encephalitis appears with paraparesis, with tetraparesis, damage to the cranial nerves, as well as various neuritis and neuralgia.

When the cranial nerves are damaged, partial paresis of the facial muscles develops, numbness occurs in half of the face, and pain occurs in the ear and pharynx. Less commonly, strabismus and swallowing disorders occur. Fortunately, after timely treatment, these manifestations quickly disappear.

Approximately 30% of patients experience paresthesia, muscle weakness in the extremities, such as mono- or polyneuritis.

Heart disorders

Most often, the peak of heart complaints begins at 6-7 weeks. There is pain in the heart, shortness of breath, dizziness, and a slow pulse. An ECG reveals myocardial dystrophy, as well as various blockades and intraventricular conduction disorders.

Lesions of the musculoskeletal system

The main complaints are pain in the ligaments, joints and muscles, which are similar to inflammatory pain, but there are no signs of inflammation (redness, soreness and heat, effusion). Usually, if the joints do not become sick within 3 months, this will not be observed in the future.

If the disease is not treated, then if pain occurs, the joints are affected a year or two from the onset of the disease, single and multiple arthritis occur, most often in knee joints, then - in the shoulders.

For the third ( late stage), which begins months or even years after the onset of the disease, the most important thing is the progression of chronic inflammation. The skin, joints, and structures of the nervous system are affected, and less commonly, other organs and tissues.

A wave-like course occurs with exacerbations and remissions, affecting large joints, soreness and swelling occur in them. From the nervous system, various sluggish encephalitis and polyneuropathies occur. Organic symptoms develop with fatigue, encephalopathy, and memory loss.

This fits into the picture of asthenovegetative syndrome, but sometimes it can be much more severe complications, For example, epileptic seizures, or the emergence of foci of demylinization, with the onset of multiple sclerosis.

In general, chronic borreliosis is a whole thick textbook, and in a short article it is impossible to tell about all the insidiousness of the disease. For example, skin lymphadenosis occurs, in which bluish-red painful nodules appear and changes characteristic of scleroderma appear.

From the side of the heart, sluggish myocarditis occurs, sometimes the pericardium is involved in the process.

Diagnosis of Lyme disease

In contrast to the course, diagnosis of the disease is quite simple; if there is ring-shaped erythema and the fact of a tick bite is proven, then tests for tick-borne borreliosis are not needed.

Everything is already clear - in this case, if erythema is not detected, then it is difficult to make a diagnosis, since borrelia are difficult to isolate from humans, and there are very few of them. That's why best solution– take the tick to the laboratory.

If a tick bites “secretly”, but there is no erythema, then a complex case arises: it is difficult to make a diagnosis. Immunoblot and ELISA methods become diagnostically significant starting from 3-6 weeks, but these methods can give high percent diagnostic errors due to slight immunity tension.

Treatment of tick-borne borreliosis, drugs

Treatment of tick-borne borreliosis, which is severe, affecting the heart and nervous system, is carried out in a hospital. The basis of therapy is antibiotics - doxycycline, amoxicillin, cephalosporins.

If the heart and joints are affected, antibiotics are prescribed last generations, pathogenetic and symptomatic treatment: hormones, NSAIDs, analgesics, vitamins are administered.

Starting from the first stage, detoxification therapy is carried out, nootropics, antiplatelet agents, and drugs that improve cerebral circulation, potassium supplements to improve heart function.

With timely treatment, all paresis and neuritis disappear, so patients with borreliosis should not be compared with stroke patients.

The main thing is not to delay seeing a doctor. The patient should begin receiving treatment the very next day after detection of erythema.

Prognosis and complications

The consequences of tick-borne borreliosis, in severe and advanced cases, can be sad: seizures, encephalopathy, heart damage and persistent disorders in the functioning of the joints occur.

This is enough for a person to become disabled, despite the fact that the prognosis is favorable for life.

It is important that immunity after Lyme disease allows for re-infection, and you can get sick with it several times in your life.

Preventing Lyme disease

Since intense immunity does not occur, there is no active immunoprophylaxis, that is, vaccination in advance is impossible.

Prevention after a tick bite if tick-borne borreliosis is suspected consists of emergency use of antibiotics: take cephalosporins, doxycycline, long-acting penicillin preparations.

The following activities are also very important:

planned measures aimed at reducing the tick population;
wearing protective clothing;
mutual and self-examinations;
using repellents when in the forest.

It is known that at least an hour passes between the crawl and the bite of the Borrelia tick, so there is enough time to take action.

In conclusion, I would like to note that there are few infectious diseases that “exhaust” a person, such as late and chronic borreliosis. At the same time, there are few diseases that, having such a clear picture in the initial period, are so easy to treat with complete recovery.

Borreliosis — dangerous disease infectious origin. The pathogen is transmitted by ticks. By the way, the disease is rightfully considered dangerous, since the lack of timely assistance leads to the development dangerous complications. At the same time, diagnosing the disease is associated with a lot of difficulties, because clinical picture sometimes it is blurred and it is difficult for the doctor to connect all the symptoms together.

Many patients are interested additional information about this disease. How can you catch an infection? What symptoms should you pay attention to? Is treatment of borreliosis with antibiotics effective? Are there effective preventive actions? The answers to these questions are important to many readers.

What is the disease?

The causes and treatment of borreliosis with antibiotics is information that many people are interested in. But first, it’s worth understanding what the disease is. Borreliosis is an infectious disease caused by Borrelia, a spirochete.

This bacterium lives in the intestines of ticks - it is through the bite of this insect that pathogenic microorganisms enter the human blood. Typically, symptoms begin to appear 7-14 days after the bite. The disease affects almost the entire body, including the nervous system, skin, musculoskeletal system, and heart.

Causes of development of borreliosis and routes of transmission of infection

Before considering treatment of borreliosis with antibiotics, it is worth learning more about the ways the infection enters the body. As already mentioned, spirochetes live in the digestive tract of ticks - they enter the human body along with saliva during a bite. But this is not the only route of infection.

The pathogen is released from the insect's grass tube along with feces. It can enter the human body through microtraumas on the skin, which happens when scratching the bite site. If the tick's body is accidentally damaged during removal, borrelia can enter the blood through the skin.

What symptoms accompany the disease?

Symptoms and treatment of borreliosis with antibiotics is information that is of interest to many. To begin with, it is worth understanding some features of the clinical picture.

The site of the tick bite usually becomes red and swollen. The formed spot becomes larger, erythema forms on the skin, the diameter of which sometimes reaches 60 cm. The affected area often itches and becomes hot. Patients complain of loss of sensitivity and a feeling of tight skin.

There are also other symptoms of intoxication, in particular, fever, aching joints, headaches, severe weakness, discomfort in the muscles. Patients also note a sore throat, annoying cough, and frequent nausea. Upon examination, you may notice an increase in lymph nodes.

If the patient has not been provided with adequate treatment, the disease enters the second stage of development. Pathogenic microorganisms enter the bloodstream and settle in different organs. Often the infection affects the nervous system, which is accompanied by impaired sensitivity and coordination, and weakened reflexes. Sometimes patients complain of problems with sleep, impaired perception of sound and light, and decreased concentration.

The disease also negatively affects the functioning of the cardiovascular system. Patients experience disturbances in heart rhythm and conduction; patients often suffer from severe pain in the chest.

Other symptoms are also present. In particular, infected people often complain of pain in the joints and muscles. Red spots (erythema) appear on the skin.

After 3-6 months (sometimes a year), the disease progresses to chronic stage, which is very difficult to treat. Periodically, the disease is activated, after which a stage of remission occurs, but even during periods of relative well-being, problems with the heart, joints, and nervous system are present.

Diagnosis of borreliosis

You should consult a doctor as soon as possible if you are bitten by a tick. Borreliosis (antibiotic treatment will be described below) is accompanied by the appearance of some symptoms. To begin with, the doctor, of course, will collect anamnesis, and then examine the bite site for the presence of characteristic erythema(redness).

However, the presence of the disease can only be confirmed in laboratory conditions. That is why, after a bite, experts recommend saving the dead tick - this way doctors will have the opportunity to conduct the necessary tests and identify Borrelia (pathogens do not live in every insect of this species).

Main goals of therapy

What does therapy look like for a disease such as tick-borne borreliosis? Treatment with antibiotics in this case is necessary. But this serious pathology which requires integrated approach. Therapy in this case pursues several goals.

Treatment of borreliosis with antibiotics is aimed at eliminating the pathogen.
In addition, the goal of therapy is to prevent the development of allergic reactions, which often occur when bitten by a tick.
It is important to strengthen immune system in order to help her cope with the inflammatory process.
It is extremely important to monitor the patient’s condition in order to prevent damage to the cardiovascular and nervous systems.
If we are talking about chronic form disease, it is important to prevent or at least reduce the number of relapses.

Don't ignore this serious illness like borreliosis. Treatment with antibiotics and other drugs helps cope with the symptoms of the disease. But the treatment regimen is always drawn up individually.

What antibiotics are used in the first days after a bite?

Immediately after a bite you should consult a doctor. If there is reason to suspect the presence of an infection, then it is necessary to immediately begin therapy. Treatment of borreliosis with antibiotics after a tick bite (in this case we are talking about the first 2-3 days) includes the use of drugs such as:

"Doxycycline" - used in the form of a solution, injections are carried out twice a day for ten days.
"Amoxiclav" - four injections per day for five days.
"Extencillin" - the solution is administered intramuscularly, and this is a one-time procedure.

Timely injections of these drugs do not guarantee complete safety patient - therapy does not end there. Nevertheless, timely use of these antibiotics halves the likelihood of further development of the disease with all associated complications.

Treatment of Lyme borreliosis with antibiotics at the first stage

It is worth saying right away that self-medication is strictly prohibited. Only a doctor can diagnose a disease such as borreliosis. Treatment with antibiotics (Doxycycline is often used for this disease) should be supervised by a specialist. Drugs are selected individually depending on the patient’s condition and the sensitivity of pathogenic bacteria to a particular drug.

Therapy should be started as soon as possible after a tick bite. If the patient does not have symptoms of damage to the joints, muscles, heart and nervous system, then the doctor prescribes Tetracycline or its analogues (with the same active ingredients). This drug reduces the risk of developing complications from the central nervous system.

If there is erythema or redness on the skin, then Doxycycline is also added to the treatment regimen. This therapy helps to quickly get rid of red spots on the body. If the patient complains of muscle pain and constant weakness, then he may be additionally assigned antibacterial agents based on penicillin.

The dosage depends on the patient’s condition, as well as the form of the drug (tablets, capsules, injection solutions). It is not recommended to reduce the amount of the drug or the number of doses even after the main symptoms have begun to disappear. It is important to maintain the required concentration of antibacterial substances in the body at all times - this is the only way to get rid of the infection.

It is worth noting that in most cases such therapy lasts about 2-3 weeks. Of course, antibiotics have a negative effect on the body, in particular digestive tract. That is why, during and after treatment, patients are also recommended to take medications to protect liver cells (Essentiale) and products containing live strains of beneficial lacto- and bifidobacteria (Linex, Bifiform). In addition, the patient is required to follow a gentle diet - the diet should be as rich in vitamins as possible and include easily digestible foods.

Treatment of borreliosis with antibiotics at stage 2

It makes no sense to prescribe the above-mentioned antibacterial agents at the second or third stage, since there will be no effect from the therapy.

What to do with an advanced form of a disease such as borreliosis? Antibiotic treatment in adults may include the following drugs:

Doctors often replace Penicillin with a drug such as Ampicillin, which contains the same antibiotic, but in a different quantity and complete with excipients. Therapy lasts from two weeks to a month - it all depends on the degree of spread of the infection, as well as the body’s response to treatment.
If the patient has neurological disorders or arthritis, the drug Ceftriaxone (or its analogs) must be included in the treatment regimen. The dosage is determined individually. The medicine is used in the form of a solution for intravenous administration. The course of treatment lasts from 10 to 14 days.
If the patient is intolerant to the above drugs, they are replaced with Erythromycin. This medicine, by the way, can also be used at the first stage of the development of borreliosis. Therapy lasts from two weeks to a month.
Increasingly, modern doctors are using so-called antibacterial drugs new generation, which also belong to the group of antibiotics wide range impact. One of the most effective remedies for borreliosis is Sumamed. The drug copes well with the symptoms of the disease. The dosage in this case is selected individually.
Another fairly effective drug is Cephobid. The product is intended for intramuscular injection, the therapy itself lasts no more than 14 days. This antibiotic affects all tissues and even body fluids. Thus, the medicine suppresses the proliferation of bacteria in all organ systems, preventing their penetration and further spread. IN modern medicine this remedy is increasingly used for treatment initial stages borreliosis.
After the main course of therapy, patients are prescribed the drug Benzathine. This remedy also penetrates body fluids and tissues, helping to destroy remaining pathogenic bacteria. This is a kind of “consolidation” of the result. In most cases, patients take this medicine for six months - according to statistics, it is in the first 6 months that relapses may develop.
Anti-tick gamma globulins are also included in the treatment regimen.

During the entire period, the patient must remain registered and undergo regular medical examinations and pass necessary tests. This way, the doctor will have the opportunity to detect the presence of complications in time and change the treatment regimen.

Treatment with folk remedies

What to do if you are diagnosed with borreliosis? Antibiotic treatment in adults gives good results. At home, the effect of therapy can be enhanced by adjusting your diet - you should include citrus fruits, herbs, blueberries, currants, cucumbers and other foods rich in vitamins in your diet. Such food helps strengthen the immune system, and this, in turn, helps the body cope with infection and its consequences.

You can also cook healing decoction. To do this, pour boiling water over a teaspoon of wild strawberry leaves, then cover the container and let the liquid brew for four hours. You need to take the strained infusion two tablespoons three times a day before meals.

It is worth understanding that folk remedies can only be used as an auxiliary therapy. Herbs help relieve soreness and inflammation. But in no case should you refuse the help of a doctor if you have a disease such as borreliosis. Treatment with antibiotics in this case is necessary. Without treatment, the disease quickly progresses and leads to the development of dangerous, sometimes even fatal, consequences.

Peculiarities of treatment for children: what to pay attention to?

In fact, borreliosis (or Lyme disease) is difficult to tolerate in childhood. The danger lies primarily in late diagnosis. The fact is that it is not always possible to tell a child that he has been bitten by a tick - young patients rarely pay attention to this. Moreover, redness on the skin can easily be confused with an allergy, and general weakness- with a cold. That is why parents take their child to the doctor at a later stage.

Nevertheless, quite often in modern pediatrics they are faced with such a problem as borreliosis. Treatment with antibiotics in children is associated with some difficulties, because these are quite aggressive drugs that can harm the growing body. Medicines must be selected very carefully.

For example, Doxycycline, which is often used in the treatment of borreliosis, has age restrictions - it cannot be prescribed to children under nine years of age. Instead, the child is prescribed drugs such as Flemoxin or Amoxil.

If a child spends a lot of time in a field, forest or park, then after walks be sure to thoroughly examine the skin for the presence of ticks or traces of their bites. Constantly ask your child how he is feeling. If your baby complains of weakness, dizziness and other symptoms that accompany borreliosis, it is better to get the necessary tests. This disease It is indeed much easier to treat at the first stage of development.

Possible complications with borreliosis

Many people faced with a similar problem are interested in questions about what the treatment and consequences of borreliosis look like. Antibiotics can cure the infection. And in most cases the prognosis is good - in 90% of cases antibacterial therapy helps get rid of symptoms and prevent the development of complications.

However, the danger still exists. Many patients complain of constant weakness, lethargy, cough, and severe headaches that occur regularly. The infection sometimes causes complications in the liver (leading to the development of hepatitis), joints (patients develop arthritis) and the heart (there is a risk of myocarditis). The disease can affect the nervous system, in particular the membranes of the brain, which can lead to progressive encephalitis and meningitis.

Experts note that this infection is extremely dangerous during pregnancy. Treatment of borreliosis with antibiotics in this case is associated with some difficulties, because it is important to select the most safe drugs. The infection can affect the fetus - there are known cases of heart defects in the child, cerebral hemorrhages and even intrauterine death. That is why a woman who has suffered from this disease must remain in a hospital until the end of pregnancy under the constant supervision of doctors. Regular ultrasound examinations are indicated, which help to detect danger in time (for example, disturbances in the development of the cardiovascular system).

Preventive actions

Treatment of the disease (borreliosis) with antibiotics takes a long time. And even if the patient was provided with full-fledged therapy, there is no guarantee that consequences will be avoided.

Treatment of borreliosis with antibiotics after a tick bite (within the first few days) is extremely important - this helps prevent further development of the disease. But even despite timely and correctly administered therapy, the patient must remain registered with a doctor for several months.