Lyme, disease

(neuroborreliosis)

Multisystemic infectious disease caused by the spirochete Borrelia garinii or burgdorferi that is transmitted to humans through the bite of a tick of the ixode type (natural reservoir: mammals, reptiles). This spirochete interbreeds slowly (resistance to treatment) and is little antigenic (late appearance of antibodies). It has an important neurotropism, which explains the occurrence of neurological signs in 10 to 15% of the patients.

In the absence of treatment, evolution in 3 phases:

-        a few days to 1 month after the bite: erythema migrans: red plate (sometimes 'rosette' appearance) that moves and is sometimes associated with an influenza-like illness symptomatology

-        neurologic manifestations (radiculitis, meningitis, facial palsy), rheumatologic (inflammatory arthritis), cardiac, or skin (benign cutaneous lymphocytoma).

-        late skin manifestations: acrodermatitis chronica atrophicans, chronic arthritis

In children, facial paralysis and lymphocytic meningitis are the most common neurologic manifestations.

Treatment:  beta-lactam or cyclin type antibiotics.


Anesthetic implications:

according to the clinical presentation


References :  

       

Updated: January 2019