Publications and scientific papers of Pasteur Institute…
Ristanović, Elizabeta; Atanasievska, Sonja; Protić-Đokić, Vesna; Hinić, Nataša; Lalošević, Dušan
In: MD Medical review, 9 (3), pp. 143-147, 2017.
Lyme borreliosis is a multi-system disease caused by Borrelia burgdorferi, which is transmitted by hard ticks Ixodes spp. The most common clinical manifestation is the skin lesion (erythema migrans), however there is a tendency of the pathogen to spread and cause damages to the joints, nervous and cardiovascular system. The diagnosis of Lyme disease is based primarily on clinical findings, epidemiological and anamnestic data and laboratory test results. The application of the modern real-time PCR method allows us to test the skin in tick bite area for a presence of B. burgdorferi. In the diagnosis of Lyme disease, we often use indirect methods (TIIF, ELISA, Western blot) for detecting specific IgM and IgG antibodies against B. burgdorferi in serum, liquor and synovial fluid. To confirm the diagnosis, the presence of IgG antibodies should be demonstrated, since the presence of IgM is not a relible indicator of a recent infection. When interpreting immunodiagnostic test results it has to be considered that there are a lot of variability as the phenotype characteristics of borrelia, different antigenic structures, different geographical distribution, phase varies in duration of the disease, characteristics of individual immune responses, presence of other diseases as well as the applied antibiotic treatment, which all can affect the outcome. Due to the high presence of infected ticks in our geographical area, it is necessary to provide continuous preventive measures, epidemiological monitoring and improvement of the diagnostic and therapeutic approach in the treatment of Lyme borreliosis.