Borelioza - diagnostyka, obraz kliniczny i terapia u ludzi i zwierzat

Borreliosis is a tick-borne, multiorgan disease, transmitted to humans and animals and caused by spiral bacteria belonging to the species Borrelia burgdorferi sensu lato. In Europe Borrelia burgdorferi sensu stricte, Borrelia afzelii and Borrelia garinii are isolated in most cases. The clinical course of the disease depends to a considerable degree on the category of the spiral bacteria in question. Borreliosis seems to be a mostly human problem. In cases of a number of animals, despite the presence of antibodies to Borrelia burgdorferi, there is no clinical evidence of the disease or its symptoms are less specific and quickly disappear. In animal cases of borreliosis the most common symptoms are found in dogs and may, as in humans, have clinical forms. There are three stages of borreliosis in humans: stage I - early infection most frequently takes the form of limited skin lesions related to Erythema chronicum migrans (ECM); stage II (generalization of the infection) - an acute inflammation of such organs as joints, the heart and the central nervous system occurs; stage III (chronic infection) - characteristic symptoms are a chronic fading inflammation of the skin, usually of limbs - acrodermatitis chronica atrophicans (ACA) - and a destructive inflammation of joints, as well as meningoencephalomyelitis. The diagnosis of borreliosis, both in humans and animals, is difficult and often problematic due to a large number of non-specific symptoms. Especially early symptoms of borreliosis may cause diagnostic difficulties. The sensitivity of serological diagnosis within the first weeks of infection may be insufficient due to false negative results. Nowadays the most critical element for the final diagnosis in humans is two-stage serological diagnostics. The first stage involves immunoenzyme tests, and in the case of a positive or doubtful result combined with non-specific clinical symptoms, it is advised to confirm the diagnosis with the Western-blot test. In the treatment of borreliosis, both in humans and animals, the main role is played by antibiotics, mainly penicillines and cephalosporins, and at the early (skin) stage, doxycykline or erythromycin as well. The length of treatment depends on the manifestations and duration of the infection and may even last up to 8 weeks.