Modérateur : aj
Med Mal Infect. 2007 Mar 15; [Epub ahead of print] Links
[What primary prevention should be used to prevent Lyme disease?][Article in French]
Service de physiopathologie et antibiologie microbiennes, EA 3432: physiopathologie des interactions hotes-bacteries, faculte de pharmacie de Strasbourg, universite Louis-Pasteur, 74, route du Rhin, BP 60024, 67401 Illkirch cedex, France.
Arthropod-borne diseases are a real public health problem. One of these, Lyme disease, is a bacterial infection due to Borrelia spp., transmitted by a hard tick, Ixodes spp.. The infection is particularly prevalent in the Northern Hemisphere and primary prevention relies on the use of repellents for cloth impregnation (pyrethroids) or for skin application (DEET). Pyrethroids and DEET are the two most studied repellents. The concentration of the active principle is essential to get a real repellent efficiency. The most efficient are: DEET at 30-50%, picaridin or KBR3023 at 20%, citriodiol at 30-50%, and IR35/35 at 20-35%. These molecules may induce adverse-effects. Considered for some time as cosmetics, a new European regulation now defines these molecules as biocides.
PMID: 17368782 [PubMed - as supplied by publisher]
Med Mal Infect. 2007 Mar 15; [Epub ahead of print] Links
[Clinical diagnosis of Lyme borreliosis in case of joint and muscular presentations.][Article in French]
Service de rhumatologie et UMR CNRS 7561, CHU de Nancy, rue du Morvan, 54511 Vandoeuvre-les-Nancy cedex, France.
The diagnosis of Lyme borreliosis in case of joint and muscular presentations is generally suggested by epidemiological factors. However, as a rule, laboratory testing is required to confirm the diagnosis. When considering the epidemiology of Lyme borreliosis in France, the only areas free of ticks infected by Borrelia burgdorgeri sl, are those close to the Mediterranean sea or at high altitude. The risk is greatest in the Alsace region. Exposure is particularly high among forest workers and people who use the countryside for their leisure activities. The likelihood of infection following a tick bite is difficult to assess; indeed, the bite site may remain unnoticed. A medical history of erythema migrans, if untreated, is a major diagnostic clue, although the association appears to be less consistent in France than in the US. Lyme arthritis generally arises apparently spontaneously. It is characteristically mono- or oligo-articular, asymmetrical, predominantly affects the knee, and has an intermittent course. Synovial cysts and enthesitis are common. Myositis is rare, polymorphic, and has been linked to other symptoms in the same localizations. Minor arthralgia and myalgia frequently occur, principally early in the course of the infection. It was suggested that sequels of the disease include so-called fibromyalgic syndromes. The principal differential diagnosis as far as arthritis is concerned, is made on spondylarthropathy and chronic juvenile arthritis. Rheumatoid arthritis is another pathology, although Lyme arthritis does sometimes evolve to chronicity.
PMID: 17368783 [PubMed - as supplied by publisher]
Med Mal Infect. 2007 Mar 26; [Epub ahead of print] Links
[Dermatological aspects of Lyme borreliosis.][Article in French]
Faculte de medecine et clinique dermatologique, universite Louis-Pasteur, 1, place de l'Hopital, 67091 Strasbourg cedex, France; GEBLY (Groupe d'etude de la borreliose de Lyme), Strasbourg, France.
Lyme borreliosis is a tick-borne zoonosis due to bacterial infection by Borrelia (B.) burgdorferi sensu lato The disease presents differently in Europe or North America and may be called European borreliosis when acquired in Europe. Lyme borreliosis evolves in 3 stages. The main manifestations include cutaneous, neurological, and joint involvement. Erythema migrans (EM) is the most specific and most frequent finding in patients with Lyme borreliosis. It is the hallmark of early-localized borreliosis. EM is a slowly expanding red macula that occurs in about 60-80% of patients contracting Lyme borreliosis. Central clearing of the red patch can occur. It appears at the site of the tick bite, 7 to 20 days after the bite. Borrelial lymphocytoma (BL) occur rarely in patients with the early-disseminated stage of the disease. BL is a red or brown nodule or plaque located on the nipple, the earlobe, the scrotum, or the face. It should not be confused with cutaneous B-cell lymphoma. Acrodermatitis chronica atrophicans (ACA) is the cutaneous manifestation of late borreliosis. It starts as a violaceous patch, usually located on the extensor surface of a limb. Periarticular nodules and cords can also be present. Without treatment, it will evolve over weeks or months to the typical atrophic stage with extensive dermo-epidermal atrophy and visibility of superficial veins. Only these 3 manifestations are clearly related to an infection with B. burgdorferi. The relationship between infection with B. burgdorferi and other dermatoses, especially morphea, lichen sclerosus, and interstitial granulomatous dermatitis is still debated.
PMID: 17391884 [PubMed - as supplied by publisher]
V Rémy de Cahors est un bon élève appliqué qui pense qu'il a qqchose à contribuer à l'avancement du Schmilblik en publiant cet article juste pour dire qu'il faut bien suivre les directives de l'EUCALB et qu'il faut s'inquiéter de la persistance des anticorps (sous-entendu sans qu'il y ait persistance de l'infection, of course!) ce qui rend le suivi difficile. De plus ces ac ne confèrent pas d'immunité, donc réinfection possible
Med Mal Infect. 2007 Mar 12; [Epub ahead of print] Links
[Biologic diagnosis of Lyme borreliosis.][Article in French]
Service de medecine interne et maladies infectieuses, centre hospitalier de Cahors, 335, rue du President Wilson, 46000 Cahors, France.
Lyme borreliosis (LB) is a multisystemic infection transmitted by ticks. Its diagnosis is based on clinical and biological criteria. These criteria could be different in Europe than in the USA, because of the existence of multiples strains of borrelia in Europe. In primary stage of LB, the diagnosis is often clinical. In the secondary stage, LB diagnosis is established with an Elisa serology confirmed by a Western blot. The interpretation criteria of these laboratory tests should follow European recommendations (EUCALB). LB with neurological involvement should be confirmed by screening for intrathecal synthesis of borrelia antibodies in CSF. LB with rheumatologic expression could be confirmed by screening for borrelia in joint fluid by PCR. There is no strong marker of activity of the disease. Follow-up for LB is difficult, because antibodies may persist for years and LB does not confer immunization.
PMID: 17360138 [PubMed - as supplied by publisher]
Presse Med. 2007 Jan;36(1 Pt 1):61-3. Epub 2006 Dec 11. Links
[Back pain without radiculitis as an initial manifestation of Lyme disease: two cases][Article in French]
Chanier S, Lauxerois M, Rieu V.
Service de Medecine, Centre Hospitalier, Thiers. email@example.com
INTRODUCTION: The most frequent neurological expression of Lyme disease (borreliosis) during its secondary phase is meningoradiculitis, but atypical presentations occur. Lyme disease must be considered especially in endemic areas and during the summer (May-October). CASES: We report cases of two patients with unusual clinical presentations of neuroborreliosis. Both had acute inflammatory back pain, resistant to the usual analgesic treatment. Both patients responded negatively to questions about tick bites and erythema migrans. Laboratory tests revealed an inflammatory process in only one patient. Lyme disease was confirmed by lymphocytic meningitis and serological tests positive for Borrelia in blood (both cases) and cerebrospinal fluid (one case). Antibiotic treatment led to the disappearance of pain and the normalization of laboratory tests. DISCUSSION: Inflammatory back pain, even without radiculitis, may be related to Lyme disease in endemic areas.
PMID: 17261450 [PubMed - indexed for MEDLINE]
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merci, c'est interressant de voir que des endroits différents publient.
Chacun redit que la borréliose européenne est différente de la borréliose américaine et ça c'est peut être une ouverture à long terme;
Ensuite le "sortez couvert et avec des répulsifs" c'est un autre truc à analyser.
Je me damende si on n'a pas sur ce forum un document signalant les risques des produits sités.
Ma mémoire me dit que Cath avait donner un truc là dessus;
Ceci expliquant cela Merci Soc!Sociando a écrit :Ce sont simplement les textes des experts de cette réunion de consensus
le niveau est...navrant?? sauf l'article de F Blanc du GEBLY qui est une bonne compil' à mon avis, exhaustive et plutôt objective et qui ne ferme pas les portes sur un éventuel élargissement des points de vue, contrairement à celui du Dr Papo !!!!!!!!!