We describe an interesting case of probable
Lyme disease with atypical features in a geographical region of Northern
Greece, in which the emergence of Borreliosis is anticipated, but not
established to date, and discuss on one hand the significance of maintaining a
high clinical suspicion on a changing planet and, on the other, the
difficulties establishing such a diagnosis. Lyme disease is an infectious
syndrome caused by various species of Borrelia, a genus of bacteria of the
spirochete phylum. The zoonosis known as Lyme disease, or Borreliosis is
spreading around the world and is transmitted to humans and small mammals by
certain tick vectors. It is linked to a range of clinical symptoms and has the
potential to cause severe disability if neglected and not properly diagnosed.
Borrelia burgdorferi s.s., Borrelia afzelii, Borrelia garinii, and Borrelia
spielmanii are the primary Borrelia species that infect humans in Europe. The
Ixodes ricinus tick is their principal vector. Although Lyme disease is considered
endemic in the Balkan region and Turkey, and all three main Lyme pathogens have
been detected in ticks collected in these countries, autochthonous Lyme disease
remains controversial in Greece. We report a case of a 21-year-old female
patient from Thasos Island in Northeastern Greece who was referred to the
Emergency Department with a progressively worsening headache of 14 days
duration and intermittent low-grade fever. The patient presented with fever and
severe headache, and the cerebrospinal fluid examination showed lymphocytic
pleocytosis. Serum analysis was positive for specific IgG antibodies against
Borrelia afzelii. For a diagnosis to be made when characteristic erythema
migrans are absent, serological evidence of infection is necessary. The seasonality
and geographic location of possible disease transmission in the reported
patient, despite the patient's unique clinical presentation, should alert
clinicians to a new infectious disease in Greece that is still contentious and
may be underreported.
Author(s)
Details:-
Dimitrios
Kouroupis
2nd Propedeutic Department of Internal Medicine,
Hippokration Hospital, 54642 Thessaloniki, Greece.
Maria
Terzaki
2nd Propedeutic Department of Internal Medicine,
Hippokration Hospital, 54642 Thessaloniki, Greece.
Nikoletta
Moscha
2nd Propedeutic Department of Internal Medicine,
Hippokration Hospital, 54642 Thessaloniki, Greece.
Anastasia
Sarvani
2nd Propedeutic Department of Internal Medicine,
Hippokration Hospital, 54642 Thessaloniki, Greece.
Elisavet
Simoulidou
2nd Propedeutic Department of Internal Medicine,
Hippokration Hospital, 54642 Thessaloniki, Greece.
Sofia
Chatzimichailidou
2nd Propedeutic Department of Internal Medicine,
Hippokration Hospital, 54642 Thessaloniki, Greece.
Evangelia
Giza
Neurology Department, Hippokration Hospital, 54642
Thessaloniki, Greece.
Georgios
Sapouridis
Department of Radiology, Hippokration Hospital,
54642 Thessaloniki, Greece.
Emmanouil
Angelakis
Hellenic Pasteur Institute, 11521 Athens, Greece.
Konstantinos
Petidis
2nd Propedeutic Department of Internal Medicine,
Hippokration Hospital, 54642 Thessaloniki, Greece.
Athina
Pyrpasopoulou
2nd Propedeutic Department of Internal Medicine,
Hippokration Hospital, 54642 Thessaloniki, Greece.
Please see the link here: https://doi.org/10.9734/bpi/rudhr/v6/355
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