Med. Pro Praxi 2007; 5: 200-203

Lymeská borrelióza

MUDr. Lenka Krbková CSc
Klinika dětských infekčních nemocí FN a LF MU, Brno

Lymeská borrelióza je způsobena v Evropě nejméně třemi genospecies komplexu Borrelia burgdorferi sensu lato, vektorem je klíště obecné. Kožním projevem je erythema migrans v místě sání klíštěte, projevující se zarudnutím s centrálním výbledem. Borreliový lymfocytom má podobu hmatného uzlíku na uchu, bradavce prsní či skrotu, nejčastěji u dětí. Chronická kožní forma acrodermatitis chronica atrophicans se vyskytuje pouze u dospělé populace. Klinické manifestace centrálního a periferního nervového systému se projevují při časné diseminované infekci, často ještě paralelně s erythema migrans. Postižení zahrnuje Garin-Bujadoux-Bannwarthův syndrom, aseptickou meningitidu a/nebo kraniální neuritidu. Lymeská artritida je nejvíce imunogenní a protilátková odpověď klesá velmi pomalu. V terapii se uplatňují betalaktamová antibiotika, tetracykliny (u dětí pouze u starších 8 let) a makrolidy v případě alergie na penicilin a nesnášenlivosti tetracyklinů. Volba antibiotika závisí na věku, na klinických projevech a na délce trvání klinických projevů. Terapeutický efekt antibiotické léčby je hodnocen zmírněním nebo vymizením klinických projevů. Zahájení antibiotické terapie pouze na základě pozitivního sérologického nálezu bez známek onemocnění není indikováno.

Keywords: Borrelia burgdorferi sensu lato, erythema migrans, borreliový lymfocytom, acrodermatitis chronica atrophicans, neuroborrelióza, lymeská artritida, antiborreliové protilátky

Published: July 1, 2007  Show citation

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Krbková L. Lymeská borrelióza. Med. praxi. 2007;4(5):200-203.
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