Borreliacidal antibodies are lethal to the spirochete Borrelia burgdorferi, the causative agent of Lyme disease. Detection of borreliacidal antibodies is useful for serodiagnosing Lyme disease and monitoring immune status after vaccination. Their detection, however, is dependent on the use of live organisms. Visual assessment of cell viability or monitoring of pH-dependent color changes in growth medium can be used to identify killing by borreliacidal antibodies, but detection by flow cytometry significantly increases sensitivity by allowing evaluation of small numbers of organisms. In addition, data from multiple assays can be rapidly acquired and analyzed objectively.
A dissociation between transcription and translation is characteristic of IL-ip and also of TNF-a (42). Despite a vigorous signal for transcription by a variety of agents, including C5a, adherence, or even hyperosmolar NaCl (42-44), most of the IL-ip mRNA is degraded and no significant translation into proIL-ip takes place. Although the IL-ip mRNA assembles into large polyribosomes, there is little significant elongation of the peptide (45). However, adding bacterial endotoxin or IL-i itself to cells with high levels of steady-state IL-ip mRNA results in augmented translation (42,44) in somewhat the same manner as the removal of cycloheximide following superinduction. One explanation is that stabilization of the AU-rich 3' untranslated region takes place in cells stimulated with lipopolysaccharide (LPS). These AU-rich sequences are known to suppress normal hemoglobin synthesis. The stabilization of mRNA by microbial products may explain why low concentrations of LPS or a few bacteria...
Inflammatory reactions in the skin usually contain a polymorphous infiltrate of T cells, B cells, plasma cells, tissue macrophages, Langerhans cells, dermal dendritic cells, and variable numbers of myeloid cells. The composition of the inflammatory cell infiltrate depends on the nature of skin injury or infection. In some conditions, such as Borrelia burgdorferi infections, secondary follicles with germinal centers are often seen. Reactive germinal centers in inflammatory conditions appear polarized with dark and light zones, have a starry sky appearance due to macrophages with ingested nuclear material from apoptotic cells, a high mitotic rate, and a distinct mantle zone of small round lymphocytes. In contrast, follicular lymphomas have a loss of polarity, few or absent starry sky macrophages, a low mitotic rate and an indistinct to absent mantle zone. In marginal zone lymphomas, the germinal centers may be partially replaced by centrocyte-like cells which are elongated B lymphocytes...
Permanent pacing is not needed in reversible causes of AV block, such as electrolyte disturbances or Lyme disease. Implantation is easier and of lower cost with single-chamber ventricular demand (VVI) pacemakers, but use of these devices is becoming less common with the advent of dual-chamber demand (DDD) pacemakers.
Immunoglobulin heavy and light chain genes are clonally rearranged. Translocation of t(9 14) gene has been reported in nodal immunocytomas (5). The Bcl-2 oncogene, normally involved in nodal follicular or follicle center lymphomas, is in germ-line configuration in cutaneous immunocytoma. In MALT lymphomas, the etiologic role of Helicobacter pylori is well established induction of reactive lymphoid hyperplasia may be followed by transformation into malignant B-cell lymphoma. Borrelia burgdorferi has been pathogenetically implicated in cutaneous B-cell pseudolymphomas and B-cell lymphomas (6-8), including immunocytoma (1).
Comment This surveillance case definition was developed for national reporting of Lyme disease it is not intended to be used in clinical diagnosis. Exposure. Exposure is defined as having been (less than or equal to 30 days before onset of EM) in wooded, brushy, or grassy areas (i.e., potential tick habitats) in a county in which Lyme disease is endemic. A history of tick bite is not required. Disease endemic to county. A county in which Lyme disease is endemic is one in which at least two confirmed cases have been previously acquired or in which established populations of a known tick vector are infected with B. burgdorferi.
Is there a generalizable recipe for the analysis of large genomic stretches for all organisms There are huge differences between organisms in the composition and overall structure of genomes. Despite the general rule that intergenic and intronic sequences have a more or less pronounced difference in AT content compared to exons, AT contents in genomes vary over a wide range. For example, the genome of Borrelia burgdorferi has a GC content of only 20 percent whereas Streptomyces coelicolor has 69 per cent GC content.
The general population of all ages and both sexes are at risk for Lyme disease, especially those who are exposed to infested geographic locations. Approximately 25 of Lyme disease cases occur in children less than 14 years of age. Reinfection via new contaminated bites is possible throughout one's lifetime. While no differences in susceptibility are known to exist in different races and ethnicities, rashes associated with Lyme disease may be difficult to see in people with a dark skin color the disease is primarily documented in the white population in the United States, who report about 75 of the cases.
Immunoassay that allows visualization of IgG antibodies to a spirochete, Borrelia burgdorferi, the agent of Lyme disease more sensitive than ELISA Note Patients may remain seropositive for long periods and the enzyme-linked immunosorbent assay (ELISA) test cannot be used as a proof of cure. A negative lyme test result does not indicate the absence of disease, nor does a positive result indicate the presence of disease. A positive result is not required to diagnose Lyme disease for someone with clear-cut erythema migrans, and those patients should be treated regardless of test results.
Research is being done on using the protein Osp A from the Lyme spirochete as a potential vaccination for this disease. Surprisingly, Osp A vaccination in mice has kept them free from Lyme disease after infected tick bites, but it also killed the spirochete that was present in the ticks who bit the vaccinated mice. Use of this vaccine might be considered in plant and water supplies to help stop the spread of Lyme disease.
Live B. burgdorferi and complement are combined with serum. After incubation for 16 to 24 hr, B. burgdorferi are stained with acridine orange, which intercalates into double-stranded nucleic acids and produces green fluorescence (maximum emission 530 nm) when excited by incident laser light (488 nm). If the serum contains borreliacidal antibodies, acridine orange enters the spirochete and concentrates in blebbed surface areas characteristic of cell death. The spirochetes are accurately evaluated by flow cytometry and live (viable) and dead, blebbed (nonviable) B. burgdorferi are discriminated by the intensity of fluorescence. Borrelia burgdorferi stock culture aliquots (see Support Protocol 3) in BSK medium Barbour-Stoenner-Kelly (BSK) medium (see Support Protocols 1 and 2) Mueller-Hinton agar plates containing B. subtilis spores (see Support Protocol 4) Serum to be tested for anti-B. burgdorferi borreliacidal antibodies Normal antibiotic-free control serum from the same species as...
The isolate of B. burgdorferi used to detect borreliacidal antibodies is critical. Borreliacidal antibodies will not be detected unless the spirochete expresses the homologous protein on the surface (Callister et al., 1996, 2002 Rousselle et al., 1998). Borrelia burgdorferi
Approximately 10-15 of patients with Lyme disease have CNS involvement. High-signal contrast-enhancing subcortical abnormalities on proton density and T2-weighted images on MRI in the frontal and parietal lobes, the basal ganglia and pons, cranial nerves (facial nerve)
Following skin abrasions, minor cuts, wounds, or burns. Tetracycline fiber Adult periodontitis. Non-FDA Approved Uses Pleural sclerosing agent in malignant pleural effusions (administered by chest tube) in combination with gentamicin for Vibrio vulnificus infections due to wound infection after trauma or by eating contaminated seafood. Mouthwash (use suspension) to treat nonspecific mouth ulcerations, canker sores, aphthous ulcers. Possible drug of choice for stage I Lyme disease.
Specific skin lesions occur in approximately 8 of patients with B-CLL. The reported incidence of cutaneous lesions ranges from 4 to 45 (3), if one takes account of nonspecific findings including purpura, ecchymoses, and maculopapular eruptions. Specific lesions usually present as red or violaceous macules, papules, or nodules (4-7). Single or multiple lesions may be present. Lesions are typically seen on the face, particularly the ears, but may also frequently be seen on the scalp, trunk, and the extremities. Generalized lesions were seen in 17 of 42 patients with specific cutaneous infiltrates of B-CLL (8). The lesions may appear at the sites of herpes simplex and herpes zoster scars they may be temporary regressing without treatment (9-11) (Fig. 1). Infection with Borrelia burgdorferi can trigger the development of specific cutaneous infiltrates which may occur at the sites typical for borrelial lym-phocytoma such as the nipple, scrotum, and earlobe (12). In addition, a predilection...
Multiple sclerosis patients present with a broad array of symptoms including reduced or abnormal sensations, weakness, vision changes, clumsiness, and loss of bladder control. The diversity of initial symptoms is a reflection of the focal nature of the disease and makes accurate diagnosis a challenge. A number of signs can be assessed to help in making the diagnosis including abnormal eye movements or pupillary response, altered reflex responses, impaired coordination or sensation, and evidence of spasticity or weakness in the arms or legs. Definitive diagnosis is made by a number of tests including blood tests to rule out other possible diagnoses (e.g., Lyme disease), an examination of cerebrospinal fluid to assess the presence of elevated immunoglobulin G (IgG), and oligoclonal banding, a visual evoked potential test to determine if there is a slowing in signal conduction, and a magnetic resonance imaging (MRI) scan to assess the presence of periventricular lesions. Multiple...
The etiology and management of Bell's palsy is controversial, although the cause is almost certainly viral. Edema of the facial nerve near the stylomastoid foramen has been demonstrated. Most Bell's palsies recover completely and spontaneously within 6 weeks. If seen in the early stages, however, antiviral treatment and prednisolone orally should be given. Providing there is no general medical contraindication to steroids, a suggested dose of prednisolone is *20 mg q.d.s. five days 20 mg t.d.s. one day 20 mg b.d. one day 20 mg o.d. one day 10 mg o.d. one day. Physiotherapy maintains tone in the muscles during recovery and also has a place in the management of Bell's palsy. Bilateral facial palsy is very rare. These cases, however, require investigation to exclude underlying disease, e.g., Lyme disease, sarcoidosis.
Adult Oval, flat, wrinkled-leathery integument, ventral mouthparts not visible dorsally except in larvae, four pairs legs with terminal claws unique paired coxal glands open between base of first 2 paired legs and filter excess sodium and water from blood-meals. Diseases Tick paralysis, tick-borne relapsing fever (Borrelia duttoni), Q-fever (Coxiella burneti).
Diseases Bacterial (Lyme disease, tularemia) rickettsial (Rocky Mountain spotted fever (RMSF), Boutonneuse and Q-fevers, Siberian tick typhus protozoal (babesiosis, ehrlichiosis) toxic (tick paralysis) arboviral enchalidides. Mechanism All stages exhibit questing behavior and blood-feed on up to three hosts sali-vary-transovarial-transstadial transmission. Eggs 1000-8000 small, spherical eggs laid in sticky, gelatinous mass in front and atop female scutum over 10 days, then female dies. Larvae Minute, seed-tick larvae hatch in 10-20 days, and resemble small adults with three (3) pairs legs quest for hosts (by warmth, CO2, vibrations) feed once a week, drop off and mature into nymphs. Nymphs One (1) instar, eight-legged. Control Peridomestic spraying acaricide dips (sheep, cattle) and pet solutions OPs, carbamates. Lyme disease
Several lines of evidence demonstrate that TLR2 recognizes components from a variety of microbial pathogens. These include lipoproteins from pathogens such as Gram-negative bacteria, Mycoplasma fermentans, Treponema pallidum, and Borrelia burgdorferi, peptidoglycan and lipoteichoic acid from Gram-positive bacteria, lipoarabinomannan from mycobacteria, glycosylphosphatidylinositol anchors from Trypanosoma cruzi, a phenol-soluble modulin from Staphylococcus epidermis, zymosan from fungi, and glycolipids from Treponema malto-philum. A prerequisite role for TLR2 in the recognition of peptidoglycan and lipoproteins has been shown in TLR2 knockout mice (Akira et al., 2001 Medzhitov, 2001). The mechanism by which TLR2 recognizes a wide variety of microbial components is now explained by the fact that TLR2 cooperates with other TLRs such as TLR1 and TLR6 to discriminate between the specific patterns.
Lathigra, R., White, O., Ketchum, K.A., Dodson, R., Hickey, E.K., Gwinn, M., Dougherty, B., Tomb, J.F., Fleischmann, R.D., Richardson, D., Peterson, J., Kerlavage, A.R., Quackenbush, J., Salzberg, S., Hanson, M., van Vugt, R., Palmer, N., Adams, M.D., Gocayne, J., Venter, J.C., et al. 1997. Genomic sequence of a Lyme disease spirochaete, Borrelia burgdorferi. Nature 390 580-586.
Action Kinetics Cefuroxime axetil is used PO, whereas cefuroxime sodium is used either IM or IV. Uses PO (axetil). Pharyngitis, tonsillitis, otitis media, sinusitis, acute bacterial exacerbations of chronic bronchitis and secondary bacterial infections of acute bronchitis, uncomplicated UTIs, uncomplicated skin and skin structure infections, uncomplicated gonorrhea (urethral and endocervical) caused by non-penicillinase-producing strains of Neisseria gonorrhoeae. Early Lyme disease due to Borrelia burgdorferi. The suspension is indicated for children from 3 months to 12 years to treat pharyngitis, tonsillitis, acute bacterial otitis media, and impetigo. Contraindications Hypersensitivity to cephalosporins. Use in infants 1 month. Early Lyme disease. 500 mg day for 20 days. Suspension