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      Enfermedad de Lyme crónica vs. Síndrome Post-tratamiento Lyme — a propósito de un caso en el ámbito laboral de Navarra Translated title: Chronic Lyme Disease vs. Lyme Post-treatment Syndrome — about a case in the Navarra workplace

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          Abstract

          Resumen Resumen: La enfermedad de Lyme es causada por la espiroqueta Borrelia Burgdoferi, que se transmite por la mordedura de la garrapata del género Ixodes. El diagnostico se realiza por ELISA y se confirma mediante Western blot o PCR. Una infección por Borrelia no solo desencadena una respuesta inmune humoral, sino que también activa la respuesta inmune celular medida por los linfocitos T, de allí la existencia del análisis Elispot-LTT, cual según la literatura científica tiene mayor especificidad y sensibilidad que incluso el Western blot. El presente caso de cuadro clínico atípico en un bombero con Enferemdad de Lyme y co-infección por Rickettsia conorii y Bartonella Heselae. Se declaró como enfermedad profesional dado que se adquirió en el ámbito laboral.

          Translated abstract

          Abstract Abstract: Lyme disease is caused by the spirochete Borrelia Burgdoferi, which is transmitted by the bite of the tick of the genus Ixodes. The diagnosis is made by ELISA and confirmed by Western blot or PCR. A Borrelia infection not only triggers a humoral immune response, but also activates the cellular immune response measured by the T lymphocytes, hence the existence of the Elispot-LTT analysis, which according to the scientific literature has greater specificity and sensitivity than even the Western blot. The present case of an atypical clinical picture in a firefighter with Lyme disease and co-infection with Rickettsia conorii and Bartonella Heselae. It was declared as a occupational disease since it was acquired in the workplace.

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          Most cited references13

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          The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America.

          Evidence-based guidelines for the management of patients with Lyme disease, human granulocytic anaplasmosis (formerly known as human granulocytic ehrlichiosis), and babesiosis were prepared by an expert panel of the Infectious Diseases Society of America. These updated guidelines replace the previous treatment guidelines published in 2000 (Clin Infect Dis 2000; 31[Suppl 1]:1-14). The guidelines are intended for use by health care providers who care for patients who either have these infections or may be at risk for them. For each of these Ixodes tickborne infections, information is provided about prevention, epidemiology, clinical manifestations, diagnosis, and treatment. Tables list the doses and durations of antimicrobial therapy recommended for treatment and prevention of Lyme disease and provide a partial list of therapies to be avoided. A definition of post-Lyme disease syndrome is proposed.
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            Functional Significance of CD57 Expression on Human NK Cells and Relevance to Disease

            Historically, human NK cells have been identified as CD3−CD56+CD16± lymphocytes. More recently it has been established that CD57 expression defines functionally discrete sub-populations of NK cells. On T cells, CD57 expression has been regarded as a marker of terminal differentiation and (perhaps wrongly) of anergy and senescence. Similarly, CD57 expression seems to identify the final stages of peripheral NK cell maturation; its expression increases with age and is associated with chronic infections, particularly human cytomegalovirus infection. However, CD57+ NK cells are highly cytotoxic and their presence seems to be beneficial in a number of non-communicable diseases. The purpose of this article is to review our current understanding of CD57 expression as a marker of NK cell function and disease prognosis, as well as to outline areas for further research.
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              Chronic Lyme disease: a review.

              Studies have shown that most patients diagnosed with chronic Lyme disease either have no objective evidence of previous or current infection with Borrelia burgdorferi or are patients who should be classified as having post-Lyme disease syndrome, which is defined as continuing or relapsing nonspecific symptoms (such as fatigue, musculoskeletal pain, and cognitive complaints) in a patient previously treated for Lyme disease. Despite extensive study, there is currently no clear evidence that post-Lyme disease syndrome is caused by persistent infection with B burgdorferi. Four randomized placebo-controlled studies have shown that antibiotic therapy offers no sustained benefit to patients who have post-Lyme disease syndrome. These studies also showed a substantial placebo effect and a significant risk of treatment-related adverse events. Further research to elucidate the mechanisms underlying persistent symptoms after Lyme disease and controlled trials of new approaches to the treatment and management of these patients are needed.
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                Author and article information

                Journal
                mesetra
                Medicina y Seguridad del Trabajo
                Med. segur. trab.
                Escuela Nacional de Medicina del Trabajo. Instituto de Salud Carlos III (Madrid, Madrid, Spain )
                0465-546X
                1989-7790
                December 2019
                : 65
                : 257
                : 285-291
                Affiliations
                [1] Pamplona Navarra orgnameFunción Pública, Interior y Justicia orgdiv1Departamento de Presidencia orgdiv2Servicio de Prevención de Riesgos Laborales España
                [2] Pamplona orgnameUnidad Docente de Medicina Del Trabajo de Navarra España
                Article
                S0465-546X2019000400285 S0465-546X(19)06525700285
                4b9ea55a-240d-4ec5-bbcc-56978836ceb4

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 03 December 2019
                : 30 November 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 14, Pages: 7
                Product

                SciELO Spain

                Categories
                Caso Clínico

                occupational exposure,medicina del trabjo,exposición ocupacional,Lyme disease,Erithema chronicum migrans,Enfermedad de Lyme,eritema crónico migrans,Occupational Medicine

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