Neuroboreliozes klīniskais raksturojums
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Date
2020
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Ievads: Laimas slimība ir endēmiska slimība Latvijā. Infekcija tiek nodota ar ērces kodumu. Šajā pētījuma tiek aprakstīti neiroloģiskie simptomi.
Pētījuma mērķis:Aprakstīt neuroboreliozes klīniskos simptomus hospitalizētajiem pacientiem.
Materiāli un metodes: Retrospektīvs pētījums, informācija tika iegūta no klīniskām vēsturēm pacientiem ar diagnosticētu neuroboreliozi Neiroloģijas nodaļā Austrumu universitātes slimnīcā no 2014. līdz 2019.gadam. Dati tika analizēti ar IBM SPSS Statistics 22.
Resultāti: Mēs analizējām klīniskās vēstures pacientiem ar diagnosticētu neuroboreliozi (n=65) no kuriem 49,2 % (n=32) bija sievietes un 50,8 % (n=33) bija vīrieši. Vidējais vecums bia 53.4 gadi (SD 15.9). Stacionētajiem pacientiem bija šādi simptomi: miegainība 9.2 % (n=6), diplopija 7.7 % (n=5), sejas palsija 18.5 % (n=12), muguras sāpes ar radikulopātiju un bilaterāla sejas palsija 6.2 % (n=4), muguras sāpes 12.3 % (n=8), neuropātiskas sāpes 10.8% (n=7), paraparēze 4.6 % (n=3), tetraparēze 4.6 % (n=3), bilaterālas toniskas kloniskas lēkmes 1.5 % (n=1), galvassāpes 13.8 % (n=9) un nespecifiski simptomi 10.8 % (n=7). Tikai 18.5 % (n=12/65) bija positīvi meningeālie simptomi. Zināms ērces kodums slimības vēsturē bija 30.8 % (n=20) un eritēma migrans 12.3 % (n=8) no pacientiem. Meningīts tika diagnosticēts 20 % (n=13), Banvarta sindroms 18.5 % (n=12), meningīts ar kraniālu neuropātiju 13.8 % (n=9), perifērā neuropātija 10.8 % (n=7), mielīts 7.7 % (n=5), koinfekcija ar ērču izraisīto enecefalītu 7.7 % (n=5), meningoecefalīts 6.2 % (n=4), izolētā kraniālā neiropātija 4.6 % (n=3)m akūta iekaisīgs poliradikuloneirīts 3.1 % (n=2), romboencefalīts 1.5 % (n=1) un neiroboreliozei nespecifiski simptomi 6.2 % (n=4). Visi pacienti saņēma specifisku antibakteriālu terapiju 14, 21 un 28 dienas. Vidējais hospitalizācijas laiks bija 18.3 dienas (SD 19.4).
Secinājumi: Lielākā daļa no pacientiem ar agrīnu Laimas slimību tika ārstēti ambulatori, kaut arī neuroboreliozes apstiprināšanai ir nepieciešama lumbālā punkcija, tas ir, hospitalizācija. Ir vajadzīga precīza diagnoze, lai pieņemtu pareizos ārstēšanas lēmumus
Introduction: Lyme disease is endemic in Latvia. Infection is transmitted by the tick bite. Neurological symptoms are described in this study. Aim of the study: To describe clinical characteristics of neuroborreliosis in hospitalized patients. Materials and methods: A retrospective study in which information was obtained from medical records of patients diagnosed with neuroborreliosis at Department of Neurology in Riga East Clinical university hospital from 2014 to 2019. Data was analysed using IBM SPSS Statistics 22. Results: We analysed medical records of patients with confirmed neuroborreliosis (n=65), among who 49.2% (n=32) were women and 50.8% (n=33) were men. Average age was 53.4 years (SD 15.9). Patients admitted with symptoms as follows: drowsiness 9.2% (n=6), diplopia 7.7% (n=5), facial palsy 18.5% (n=12), backaches with radiculopathy and bilateral facial palsy 6.2% (n=4), backaches 12.3% (n=8), neuropathic pain 10.8% (n=7), paraparesis 4.6% (n=3), tetraparesis 4.6% (n=3), bilateral tonic-clonic seizure 1.5% (n=1), headaches 13.8% (n=9) and non-specific symptoms (dizziness or general weakness) 10.8% (n=7). Only 18.5% (n=12/65) had positive meningeal signs. Known tick bite in history was in 30.8% (n=20) and erythema migrans in 12.3% (n=8) of patients. Meningitis was diagnosed in 20% (n=13), Banwarth syndrome 18.5% (n=12), meningitis with cranial neuropathy 13.8% (n=9), peripheral neuropathy 10.8% (n=7), myelitis 7.7% (n=5), coinfection with tick-borne encephalitis 7.7% (n=5), meningoecephalitis 6.2% (n=4), isolated cranial neuropathy 4.6% (n=3), acute inflammatory polyradiculoneuritis 3.1% (n=2), rhombencephalitis 1.5% (n=1) and neuroborreliosis with non-specific symptoms in 6.2% (n=4). All of the patients received specific antibacterial treatment for 14, 21 or 28 days. The average length of stay in hospital was 18.3 (SD 9.4) days. Conclusion. Most patients with early Lyme disease are treated as outpatients while a confirmation of neuroborreliosis requires lumbar puncture and hence requires the hospitalization. Precise diagnosis is needed to make the right treatment decisions.
Introduction: Lyme disease is endemic in Latvia. Infection is transmitted by the tick bite. Neurological symptoms are described in this study. Aim of the study: To describe clinical characteristics of neuroborreliosis in hospitalized patients. Materials and methods: A retrospective study in which information was obtained from medical records of patients diagnosed with neuroborreliosis at Department of Neurology in Riga East Clinical university hospital from 2014 to 2019. Data was analysed using IBM SPSS Statistics 22. Results: We analysed medical records of patients with confirmed neuroborreliosis (n=65), among who 49.2% (n=32) were women and 50.8% (n=33) were men. Average age was 53.4 years (SD 15.9). Patients admitted with symptoms as follows: drowsiness 9.2% (n=6), diplopia 7.7% (n=5), facial palsy 18.5% (n=12), backaches with radiculopathy and bilateral facial palsy 6.2% (n=4), backaches 12.3% (n=8), neuropathic pain 10.8% (n=7), paraparesis 4.6% (n=3), tetraparesis 4.6% (n=3), bilateral tonic-clonic seizure 1.5% (n=1), headaches 13.8% (n=9) and non-specific symptoms (dizziness or general weakness) 10.8% (n=7). Only 18.5% (n=12/65) had positive meningeal signs. Known tick bite in history was in 30.8% (n=20) and erythema migrans in 12.3% (n=8) of patients. Meningitis was diagnosed in 20% (n=13), Banwarth syndrome 18.5% (n=12), meningitis with cranial neuropathy 13.8% (n=9), peripheral neuropathy 10.8% (n=7), myelitis 7.7% (n=5), coinfection with tick-borne encephalitis 7.7% (n=5), meningoecephalitis 6.2% (n=4), isolated cranial neuropathy 4.6% (n=3), acute inflammatory polyradiculoneuritis 3.1% (n=2), rhombencephalitis 1.5% (n=1) and neuroborreliosis with non-specific symptoms in 6.2% (n=4). All of the patients received specific antibacterial treatment for 14, 21 or 28 days. The average length of stay in hospital was 18.3 (SD 9.4) days. Conclusion. Most patients with early Lyme disease are treated as outpatients while a confirmation of neuroborreliosis requires lumbar puncture and hence requires the hospitalization. Precise diagnosis is needed to make the right treatment decisions.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
neuroborelioze, hospitalizācija, neuroborreliosis, hospitalization