Neth J Med. 2011 Mar;69(3):101-11.
Tired of Lyme borreliosis. Lyme borreliosis in the Netherlands.
Coumou J, van der Poll T, Speelman P, Hovius JW.
Center for Experimental and Molecular Medicine (CEMM), Academic Medical
Center (AMC), University of Amsterdam (UvA), the Netherlands.
Lyme borreliosis has become the most common vector-borne illness in
North Eastern USA and Europe. It is a zoonotic disease, with
well-defined symptoms, caused by B. burgdorferi sensu lato, and
transmitted by ticks. Lyme borreliosis is endemic in the Netherlands
with a yearly incidence of approximately 133 cases÷100,000 inhabitants.
Similar to another spirochetal disease, syphilis, it can be divided into
three stages; early, early disseminated and late disseminated
manifestations of disease, of which the specific clinical presentations
will be discussed in detail. The diagnosis of Lyme borreliosis is based
on a history of potential exposure to ticks and the risk of infection
with B. burgdorferi s.l., development of specific symptoms, exclusion of
other causes, and when appropriate, combined with serological and÷or
other diagnostic tests. The specific indications for, but also the
limitations of, serology and other diagnostic tests, including the
polymerase chain reaction (PCR), are detailed in this review. Lyme
borreliosis is treated with antibiotics, which are usually highly
effective. Recent literature discussing the indications for antibiotic
treatment, the dosage, duration and type of antibiotic, as well as
indications to withhold antibiotic treatment, are reviewed. This review
presents the most recent, and when available Dutch, evidence-based
information on the ecology, pathogenesis, clinical presentation,
diagnosis, treatment and prevention of Lyme borreliosis, argues against
the many misconceptions that surround the disease, and provides a
framework for the Dutch physician confronted with a patient with
putative Lyme borreliosis.
PMID: 21444934 [PubMed - in process]
Free Article <www.njmonline.nl/njm/cntpdf.php?t=a&id=10000693>
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