| Titre : | Lyme borreliosis. (1998) |
| Auteurs : | R.B. NADELMAN ; G.P. WORMSER ; Department of Medicine. Division of infectious Diseases. New York Medical College. And Lyme Disease Diagnostic Center. Westchester Medical Center. Valhalla NY. USA |
| Type de document : | Article |
| Dans : | Lancet (The) (vol. 352, n° 9127, 1998) |
| Pagination : | 557-565 |
| Langues: | Anglais |
| Mots-clés : | Bactériose ; Infection ; Bactérie ; Epidémiologie ; Symptôme ; Examen bactériologique ; Prévention santé ; Thérapeutique ; Etats Unis ; Amérique du Nord ; Amérique ; Homme |
| Résumé : | [BDSP. Notice produite par INIST SFNAFR0x. Diffusion soumise à autorisation]. Lyme borreliosis (Lyme disease) is often said to be assoclated with "protean manlfestations, a reference to the ancient god Proteus, who could assume many forms and thus elude his pursuers. This legendary quality has clouded our understanding of Lyme borreliosis by giving Borrelia burgdorferi Infection a mythical aura of its own. This review shows that this illness, while incompletely understood, is far more palpable than Proteus and is (in most cases) much more readily subdued. The clinical presentations of Lyme borreliosis do differ In North America and Eurasia, possibly due to the differing pathogenicity of distinct genospecies of Borrelia burgdorferi. The most common manifestation, however, in both continents Is erythema migrans. Diagnosis should rest on a careful history and objective clinical findings, supported by appropriately chosen laboratory tests. Reports of coinfection with other tick-bome diseases should prompt a fresh look at Lyme borrellosis. Assertions about" protean manifestations "of B burgdorferi infection should be reappraised. Advances in laboratory techniques are welcome but culture remains the gold standard for the diagnosis-and no laboratory test result should substitute for careful clinical observation and critical analysis. |
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