Laboratorial study of tick-borne infectious agents in patients with brazilian Lyme-like disease (Baggio-Yoshinari Syndrome) / Estudo laboratorial de agentes infecciosos transmitidos por carrapatos em pacientes com doença de Lyme-símile brasileira (síndrome Baggio-Yoshinari)

AUTOR(ES)
DATA DE PUBLICAÇÃO

2010

RESUMO

Human Monocytic Ehrlichiosis, Human Granulocytic Anaplasmosis, Babesiosis, Rocky Mountain Spotted Fever and Lyme Disease (LD) are tick-borne diseases commonly found in the North hemisphere. In Brazil, a LD-like illness called Baggio- Yoshinari Syndrome (BYS) is described, but epidemiological, clinical and laboratorial features are different from the original LD. In Brazilian humans, the other tick-borne diseases are less frequently studied. The aim of this survey was to verify the possibility of co-infections between BYS and other tick-borne diseases, using laboratorial assays to Ehrlichia spp, Babesia spp and Rickettsia spp in a group of 70 patients with BYS. Ten patients were at initial stage of the disease and 60 patients were in a latent stage. Erythema migrans (EM) was present in 27 patients (38.6%), arthritis in 26 (37,1%), fever in 13 (18.5%), headache in 29 (41.4%) arthralgia in 36 (51.4%), myalgia in 51 (72,8%), fatigue in 38 (54,3%), meningitis in 4 (5.7%), cranial neuritis in 8 (11.4%), peripheral radiculopathy in 9 (12.8%), encephalomyelitis in 4 (5.7%), cardiopathy in 7 (10%), atypical skin eruptions in 10 (14.3%) and anemia in 10 patients (14.3%). ELISA (Enzyme Linked Immunossorbent Assay) for Borrelia burgdorferi antigens was positive in 21 patients (30%) of BYS group, while only 3 (6%) from 50 normal individuals had positive reactions (p = 0.01). Using the modified Western Blotting (WB) method for B. burgdorferi antigens, 35 (50%) of the BYS patients were positive, and 2 normal individuals (4%) from the control group (p 0,001). Indirect Immunofluorescence Assay (IFA) (IgG) presented positive results for three of five species of Rickettsia tested: R. parkeri (8, 6%) (p = 0,032), R. amblyommii (22.8%) (p = 0,031) and for R. bellii (8.6%) (p = 0,032). Chi-square test was used for the statistic analysis. A few patients developed a positive reaction to B. bovis (IFA and ELISA) and B. equi antigens (IFA). IFA for Ehrlichia canis antigens was positive in only one patient (1.4%) with BYS. It was possible to conclude that BYS patients presented a coinfection with R. parkeri, R. amblyommi and R. bellii, suggesting that BYS can be vectored by the same ticks responsible for the transmission of Rickettsial agents.

ASSUNTO(S)

ehrlichiose/diagnóstico rickettsia amblyommii rickettsia bellii síndrome baggio-yoshinari zoonoses rickettsia bellii rickettsia rickettsia parkeri rickettsia ehrlichiose/diagnóstico rickettsia amblyommi zoonoses baggio-yoshinari syndrome rickettsia parkeri

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