Key characteristics of tick-borne borreliosis, treatment methods

Tick-borne borreliosis (also known as Lyme borreliosis and Lyme disease) is a contagious disease of natural focal origin, characterized by disruption of various metabolic reactions. The disease is caused by three species of Borrelia. Below, we'll discuss what tick-borne borreliosis is, its nature, symptoms, and treatment options.

Causes of tick-borne borreliosis

Scientists have established that the disease is caused by three categories of Borrelia bacteria: Borrelia burgdorferi, Borrelia garinii, and Borrelia afzelii. The latter two bacterial species are more common in Europe, while the first species is more common in the Americas, having already been identified in more than 25 US states.

The carriers of the tick-borne borreliosis pathogen are Ixodes ticksThey are capable of migration, attaching to the bodies of migratory birds or dogs. The bacteria are shaped like a coiled spiral and are very small. Besides dogs and birds, the following animals serve as natural reservoirs:

• rodents;
• horses;
• cows;
• goats;
• deer and others.

Ticks that carry borreliosis become infected by sucking the blood of infected animals and capable of transmitting borrelia to their offspring. These ticks are primarily found in temperate climates, in mixed forests. Endemic areas of tick-borne borreliosis worldwide are:

1. Northwest and central Russia.
2. Ural.
3. Western Siberia.
4. Far East.
5. Partially Europe.
6. USA.

In these regions, tick infestation rates reach up to 60 percent. The peak of this disease is in late spring and early summer, when tick activity is increased and humans have high susceptibility to borrelia, accordingly, is at high risk of contracting tick-borne borreliosis.

The course of the disease

A person becomes infected with Lyme disease through a tick bite. The pathogen, injected into the skin via saliva, begins to multiply. It then travels to the lymph nodes, where it continues to multiply.

A few days later, Borrelia pass into the bloodstream throughout the body with the bloodstream. They reach the following organs:

• Heart.
• Central nervous system.
• Muscles.
• Joints.

They can remain there for a very long time and then reproduce again. The immune system produces antibodies against Borrelia, but even this doesn't completely eliminate the pathogen that causes tick-borne borreliosis.

And the immune complexes that appear as a result of it, trigger an autoimmune processThis causes the disease to become chronic, and the pathogen dies, which is accompanied by the release of toxic substances, worsening the person's condition. However, it is not contagious to others.

Symptoms of tick-borne borreliosis

Often, even doctors confuse this disease with the following illnesses: myocarditis; meningitis; arthritis; neuritis. The key symptoms of the disease are as follows:

• temperature;
• headache;
• vomit;
• nausea;
• spots on the skin;
• muscle aches;
• weakness.

Stages of tick-borne borreliosis

This disease includes several stages:

1. The incubation period (from infection to the first symptoms) is from 3 to 32 days.
2. The first stage is the period of reproduction of borrelia in the areas of penetration and lymph nodes.
3. The second stage is the time when the pathogen spreads throughout the body along with the blood.
4. The third stage is the chronic stage. During this time, a specific system of the body (nervous or musculoskeletal) is primarily affected.

The first two stages represent the early period of infection, while the third represents the late stage. The distinction between them is arbitrary.

Description of the first stage of tick-borne borreliosis

During this period, local and general manifestations of tick-borne borreliosis are observed. General symptoms include:

• Headache.
• Muscle pain.
• Aches and pains.
• Joint pain.
• Elevated temperature up to 38 degrees.
• Chills.
• Vomiting and nausea.
• General malaise.

Rarely observed pain and sore throat, a slight cough and a runny nose. Local symptoms look like this:

• the appearance of swelling at the site of the bite;
• painful sensations;
• redness;
• itching.

Erythema

A specific symptom of tick-borne borreliosis is annular erythema, which occurs in 70 percent of cases. A papule, a firm lesion that expands over time, also forms at the site of the bite. has a ring shape.

In the middle of it is the bite site, which is very pale, and the rim is more red and rises above the unaffected area of ​​​​the skin.

The reddened area is oval or round, with a diameter of approximately 10–60 cm. Smaller rings are often present within the ring, especially if the erythema is extensive. In most cases, it is not painful, but it can burn or itchErythema is often the first sign of Lyme disease and causes no reaction. Subsequently, new erythemas may appear, even in areas where there were no bites.

The erythema lasts for about a month, sometimes it can be a few days, and sometimes several months. Then it disappears and leaves behind pigmentation and peelingA rash similar to hives or conjunctivitis may also often appear on the skin.

Other local symptoms of the first stage include:

1. Enlargement and pain in the lymph nodes.
2. Increase in temperature.
3. Stiffness of the neck muscles.
4. Joint and muscle pain.

Often, in the first stage of the disease, symptoms disappear even without treatment.

The second stage of the disease

This stage of tick-borne borreliosis is accompanied by the following features: damage to the joints and skin; heart and nervous system.

This stage can last from a few days to a month, during which time all symptoms of the first stage disappear. In some cases, Lyme disease begins immediately in the second stage, without the general infectious syndrome or annular erythema.

Damage to the nervous system manifests itself through serous meningitis, affecting the cranial nerves and spinal nerve roots.

Serous meningitis is understood as inflammation of the meningesIt manifests itself as a moderate headache, photophobia, increased sensitivity to stimuli, tension in the occipital muscles, and severe fatigue.

This type of meningitis may be asymptomatic, but the following may be observed:

• emotional disorders;
• insomnia;
• problems with attention and memory;
• an increase in the amount of protein and lymphocytes in the cerebrospinal fluid.

Other symptoms of the second stage

The cranial nerves, especially the facial nerve, are often affected, manifesting as paralysis of the facial muscles: the face becomes distorted; the eye may not close completely; food may fall out of the mouth while eating.

Sometimes one side is affected, sometimes both. It's worth noting that with Lyme disease, the facial nerve is affected, but this provides grounds for recovery. Common symptoms can be observed. deterioration of hearing and vision, strabismus develops and eye movement is impaired.

The spinal nerve roots are affected, resulting in shooting pain. In the torso, the pain may be girdle-like, and in the extremities, it radiates downwards. After a few days or weeks, muscles are affected, which manifests itself in the form of paresis, increased or decreased general sensitivity, and loss of tendon reflexes.

The nervous system, often affected by tick-borne borreliosis, is accompanied by the following symptoms:

• Speech impairment.
• Instability.
• Involuntary movements.
• Trembling of the limbs.
• Problems with swallowing.
• Epileptic seizures.

All this can occur in 10 percent of cases of the disease. Joints are affected in the form of recurrent monoarthritis or oligoarthritisThis affects the hip, ankle, knee, and elbow joints. Pain appears and mobility is limited.

The heart can be affected in different forms:

1. Heart conduction is impaired.
2. Myocarditis and pericarditis appear.
3. The heartbeat is disturbed.
4. Shortness of breath appears.
5. The appearance of pain behind the breastbone.
6. Heart failure.

Skin disorders at this stage can also be different: a rash like urticaria and lymphocytomas; secondary annular erythema.

Lymphocytoma is a specific symptom of Lyme borreliosis and appears as a red nodule, ranging from a few millimeters to centimeters in size, that protrudes above the skin. It often appears in the groin area, on the nipple, or on the earlobe.

In the second stage of tick-borne borreliosis, other organs and systems are also affected, but not as often:

• bronchi;
• kidneys;
• liver;
• testicles;
• eyes.

Characteristics of the third stage of the disease

The third stage of Lyme disease can begin several months or even years after the onset of the disease. It can manifest as chronic arthritis; atrophic skin lesions; lesions of the nervous system.

Quite often, the disease can affect one or another system, affecting either the joints, the nervous system, or the skin. Combined lesions are also common.

Chronic arthritis can affect both large and small joints. The disease often relapses, gradually joints begin to deform, cartilage tissue thins, and osteoporosis develops. This is often accompanied by chronic myositis.

With atrophic acrodermatitis, you may see: bluish-red spots On the knees and elbows, as well as on the backs of the hands and soles of the feet. The skin in these areas thickens and swells, and with relapses and prolonged illness, the skin becomes like tissue paper.

In the third stage of tick-borne borreliosis, the nervous system is affected in different ways:

• In the form of paresis.
• Increased sensitivity.
• Disturbances of balance.
• Problems with memory and thinking.

It happens often epileptic seizures, hearing and vision are impaired, and pelvic problems develop. Weakness, lethargy, and depression are observed. If left untreated, Lyme disease eventually becomes chronic, characterized by recurrence.

Tests for tick-borne borreliosis

A diagnosis of tick-borne borreliosis is made based on clinical findings such as a tick bite and the presence of annular erythema, as well as laboratory tests. Often, the tick bite goes unnoticed and there is no erythema, with symptoms only appearing in the second stage, so the disease can be detected. only by laboratory method.

Borrelia are very difficult to detect; they are visible in infected fluids or tissues. Biopsies are often performed, but the yield is not very high, so indirect diagnostic methods are often used, such as polymerase chain reaction and serological diagnostics.

Often used in diagnostics search for DNA fragments, and it is more accurate than the use of serological reactions, which give false indications in the presence of syphilis, infectious mononucleosis or rheumatic diseases.

There are seronegative variants of tick-borne borreliosis, but in the early stages, serological testing fails to confirm the disease in half of cases. Therefore, testing must be conducted dynamically.

How to treat borreliosis

Treatment for tick-borne borreliosis depends on the stage of the disease. There are two treatment approaches: etiotropic, which targets the pathogen; and symptomatic and pathogenetic, which treat the affected organs and systems.

At the first stage of tick-borne borreliosis, as etiotropic treatment prescribe antibiotics to the patient inside. These include:

1. Tetracycline.
2. Doxycycline.
3. Amoxicillin.
4. Cefuroxime.

Antibiotics are taken for approximately two weeks. The dosage should never be reduced or the duration of treatment shortened, as this allows some Borrelia to survive and begin to multiply again.

At the second stage, parenteral treatment with antibiotics is prescribed, penicillin and ceftriaxone are prescribedIn this case, antibiotics are taken for 14 to 21 days, and this ensures a cure for the disease in most cases.

In the third stage of the disease, the recommended duration of antibiotic use is at least 28 days. For this purpose, penicillin antibioticsDuring this time, the patient is given 224 injections and a prolonged form of the drug is used.

If there is no effect from using a particular antibiotic or there is no positive dynamics during the cerebrospinal fluid examination, then the antibiotic must be changed.

Through antibiotics preventive therapy is being carried outIt is prescribed to those who seek medical attention within 5 days of a tick bite, when the tick was brought in or removed by a doctor, or if Borrelia is detected under a microscope. In such cases, the doctor prescribes:

• Tetracycline.
• Doxycycline.
• Amoxiclav.
• Retarpen.

In most cases, such prevention helps get rid of the disease. There is also pathogenetic and symptomatic treatment, which involves the use of drugs of this kind:

• antipyretic;
• anti-inflammatory;
• detoxification;
• general tonic;
• cardiac;
• vitamin.

The use of a particular drug depends on the stage and form of tick-borne borreliosis.

Consequences of the disease

If tick-borne borreliosis is detected in the first stage and treated fully, a full recovery occurs. In the second stage, the disease is cured in most cases without sequelae.

If diagnosis is delayed, treatment is incomplete, or there are defects in the immune response, the disease may progress to the third or chronic stage. In these forms, even with repeated courses of therapy and treatment, the patient does not fully recover.

His condition may improve, but there will be functional disorders, which can cause disability:

1. Decreased muscle strength in the arms or legs.
2. Sensitivity is impaired.
3. The face is deformed due to damage to the facial nerve.
4. Vision and hearing are impaired.
5. Unsteadiness appears when walking.
6. Epileptic seizures.
7. The joints become deformed and their functions are impaired.
8. Arrhythmia.
9. Heart failure.

Not all of these symptoms are always present in stage three or chronic cases. Improvement can be observed even in advanced cases, and even slow recovery is common.

Preventive measures for tick-borne borreliosis

There is no specific vaccine or preventative measure against tick-borne borreliosis. To prevent this disease, basic precautions should be taken in areas where insects and ticks congregate:

• Wear long sleeves and long pants.
• Shoes should be high.
• Wear a hat.
• Apply protective agents to clothing.
• An attached tick should be unscrewed, do not press on it or pull it out vertically.
• Treat your hands and wounds.

Tick-borne borreliosis is dangerous disease An infectious disease that often develops unnoticed, especially if a person hasn't noticed the bite. Initially, annular erythema appears, and various organs are affected. The disease is confirmed by laboratory tests.

This the disease can be cured, if antibiotics are used early. Otherwise, the disease becomes chronic and can cause irreversible damage.