Reinfection in patients with Lyme disease
Reinfection in patients with Lyme disease
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DOI：
10.1086/521256
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发表时间：
2007-10-15
影响因子：
11.8
通讯作者：
Wormser, Gary P.
中科院分区：
文献类型：
--
作者：
Nadelman, Robert B.;Wormser, Gary P.
莱姆病是美国和欧洲最常见的蜱传感染。令人惊讶的是，许多患者在第一次发病后又经历了莱姆病的后续发作。只有在成功治疗早期感染（几乎总是游走性红斑）后，才有充分的记录，并且在临床上通常可以通过主要蜱虫媒介在环境中丰富的几个月内在皮肤上不同部位发生的游走性红斑重复发作来识别。有限的数据表明，莱姆病伴游走性红斑患者再感染的临床和实验室表现与初次感染没有很大不同。反复感染的患者提供了一个研究免疫反应在这种疾病中的作用的机会。由于早期莱姆病患者继续处于再感染的高风险中，因此应针对这一人群进行莱姆病预防教育。
Lyme disease is the most common tick-borne infection in the United States and Europe. A surprising number of patients experience a subsequent episode of Lyme disease after the first episode has resolved. Reinfection has been well-documented only after successfully treated early infection (nearly always erythema migrans) and can often be recognized clinically by the development of a repeat episode of erythema migrans occurring at a different location on the skin during months when the principal tick vectors are abundant in the environment. Limited data suggest that the clinical and laboratory manifestations of reinfection in patients with Lyme disease with erythema migrans are not very different from those of initial infection. Patients with recurrent infections afford an opportunity to study the role of the immune response in this illness. Because patients with early Lyme disease continue to remain at high risk for reinfection, this population should be targeted for education about prevention of Lyme disease.