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首页> 外文期刊>Clinics in dermatology >Lyme disease/borreliosis as a systemic disease
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Lyme disease/borreliosis as a systemic disease

机译：莱姆病/贝氏体病为全身性疾病

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Lyme disease/borreliosis (LD) is a well-known arthropod-transmitted entity in the northern hemisphere. The incidence of LD is reportedly rising throughout the world, although better diagnostic facilities may be contributory. The disease distribution is expanding in Europe, with its presence being now documented at higher altitudes and latitudes. Borrelia burgdorferi sensu lato is the most important genospecies leading to LD, although newer ones continue to be discovered. The variations in clinical spectrum with genospecies involved are an interesting feature. The alteration in gene expression while the organism cycles between two very different hosts is intriguing and has been described. The disease presents in three stages namely, the early localized, early disseminated, and late stage. Erythema chronicum migrans is the pathognomic early lesion, and its diagnosis is purely clinical; however, laboratory diagnosis is essential for later manifestations. Two-tier serologic testing using an enzyme-linked immunosorbent assay (ELISA) as the first tier and immunoglobulin M (IgM) and IgG immunoblot as the second, if ELISA is positive or equivocal, is the mainstay of diagnosis. Doxycycline is the cornerstone of treatment, whereas parenteral therapy, mainly with ceftriaxone, is indicated in a few specific scenarios. (C) 2015 Elsevier Inc. All rights reserved.
机译：莱姆病/疏螺旋体病（LD）是北半球众所周知的节肢动物传播实体。据报道，尽管有更好的诊断手段，LD的发病率在全世界范围内也在上升。该疾病的分布在欧洲正在扩大，据记录在高海拔和高纬度地区都有存在。伯氏疏螺旋体是导致LD的最重要的基因种，尽管仍在不断发现新的基因。涉及基因型的临床频谱变化是一个有趣的特征。有趣的是，当生物体在两个非常不同的宿主之间循环时，基因表达的变化是令人感兴趣的，并且已经进行了描述。该疾病表现为三个阶段，即早期本地化，早期传播和晚期。慢性红斑移行性红斑是病理性早期病变，其诊断纯属临床。但是，实验室诊断对于以后的表现至关重要。诊断的主要手段是使用酶联免疫吸附测定（ELISA）作为第一层，使用免疫球蛋白M（IgM）和IgG免疫印迹作为第二层的两层血清学检测。强力霉素是治疗的基石，而在某些特定情况下则表明主要采用头孢曲松的肠胃外治疗。 （C）2015 Elsevier Inc.保留所有权利。

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