Fatigue, persistence after Lyme borreliosis 196, 197 Francisella tularensis, see Tularemia

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1 Subject Index Acrodermatitis chronica atrophicans (ACA) antibiotic therapy 121, 122 Borrelia induction 13 clinical characteristics 64, 65, 82 diagnosis 65, 66 differential diagnosis 66 etiology 62 frequency 62 histologic findings 63, 64 Lyme borreliosis diagnosis 53 tick bite history 63 Age distribution, Lyme borreliosis 38, 39, 44 Altitude, Lyme borreliosis influences 37 Anaplasmosis clinical presentation 132, 133 epidemiology 132 laboratory findings 133 pathogens 131 treatment 133 vectors 131, 132 Antibiotic therapy acrodermatitis chronica atrophicans 121, 122 anaplasmosis 133 borrelial lymphocytoma 121 early disseminated and late Lyme borreliosis Lyme arthritis Lyme neuroborreliosis overview early Lyme borreliosis erythema migrans 111, 112, 161 Lyme carditis 122 persistent symptoms following treatment cutaneous manifestations 192 fatigue 196, 197 Lyme arthritis 193 Lyme neuroborreliosis, 196 overview 191, 192 subjective symptoms 197, 198 post-lyme disease and late-stage borreliosis 120, 121 pregnant patients with Lyme borreliosis prophylaxis 185, 186 treatment prophylaxis after tick bites 126, 127, 161 rickettsiosis 150 spectrum of activity against Borrelia 112, 113 tick-borne relapsing fever 136 tularemia 139, 140 Antibody serology antigen preparations and diagnostic formats 168, 169 follow-up in cutaneous Lyme borreliosis Lyme borreliosis diagnosis rational stepwise testing 167, 168, Western blot diagnostic value 173, 174 interpretation 175, 176 line immunoblot 172 overview 169, 170 recombinant immunoblot 171 stage-dependent antibody kinetics 172, 173 whole cell antigen immunoblot 170, 171 Arthritis, see Lyme arthritis Astrakhan fever, features 146

2 Babesiosis clinical presentation 142, 143 diagnosis 143 epidemiology 142 pathogens and vectors 141, 142 treatment 143 BbK32, pathogenicity factor 4 BgP, pathogenicity factor 4 Borrelia afzelii 8 Borrelia andersonii 10 Borrelia bisettii 8, 9 Borrelia burgdorferi sensu lato complex, see also individual species antibiotic activity 112, 113 Borrelia burgdorferi sensu stricto 5 7 genetic diversity analysis 2, 3 genome 11, 12, genomospecies 2, 10 geographic distribution 10, 21, 22 hosts 11, 12, invasiveness 12, 13 life cycle organotropism and lateral transfer 13 pathogenicity 3 5, 13 seropositivity in healthy individuals 157 taxonomy 1, 2, 21, 200 transmission 2, vectors 11, 12, Borrelia californiensis 10 Borrelia garinii 7 Borrelia japonica 9 Borrelia lonestari 2 Borrelia lusitaniae 9, 12 Borrelia sinica 9 Borrelia spielmanii 8 Borrelia tanukii 9 Borrelia turdi 9 Borrelia valaisiana 9, 12 Borrelial lymphocytoma, see Lymphocytoma, borrelial Carditis, see Lyme carditis Cerebrospinal fluid (CSF), Lyme neuroborreliosis findings 96, 97, 100, 203, 204 Chronic Lyme borreliosis, features 93, 94 Complement regulator-acquiring surface factors 4 Culture, Lyme borreliosis diagnosis 97 Cutaneous lymphoma, clinical findings 68, 69 Dbp proteins, pathogenicity factors 4 Dermatomyositis, Lyme borreliosis 93 Diagnosis acrodermatitis chronica atrophicans 65, 66 borrelial lymphocytoma 61, 62 erythema migrans 58 Lyme arthritis 89 Lyme borreliosis laboratory diagnosis overview Lyme carditis 77, 78 Lyme neuroborreliosis 73, 74 tick-borne relapsing fever 136 tularemia 138, 139 Enzyme-linked immunosorbent assay (ELISA) Lyme borreliosis diagnosis tick-borne encephalitis 141 Eosinophilic fasciitis, Lyme borreliosis 93 Epidemiology, Lyme borreliosis age distribution 38, 39, 44 altitude influences 37 geographic distribution incidence rates trends 36 latitude influences 36, 37 occupational factors 44, 50 risk assessment behavior 44 duration of tick attachment 42 indices 43, 44 seroconversion rate 158, 159 transmission 41, 42, 157, 158 vector tick stage 41 seasonal distribution 38 sex differences 39, 40, 44 surveillance 44, 45 urban versus rural differences 40 weather influences 40, 41 Erythema migrans (EM) antibiotic therapy 111, 112, 161 Borrelia induction 13 clinical characteristics 56 58, 80 definition 54, 55 diagnosis 58 differential diagnosis 58, 59 etiology 55, 56 eye involvement 91 frequency 55 Subject Index 209

3 Erythema migrans (EM) (continued) histologic findings 56, 81 immunocompromised patients Lyme borreliosis diagnosis 53 natural evolution 192 persistent disease management corticosteroid injections intra-articular 194 systemic disease modifying anti-rheumatic drugs nonsteroidal anti-inflammatory drugs synovectomy 194, risk assessment 158, 159 tick bite lesions 56 Eye involvement, Lyme borreliosis Fatigue, persistence after Lyme borreliosis 196, 197 Francisella tularensis, see Tularemia Geographic distribution Borrelia burgdorferi sensu lato complex 10, 21, 22 Ixodes ricinus 19 Lyme borreliosis Hydroxychloroquine, Lyme arthritis management Hypersensitivity reactions, tick bites 160 Immunocompromised patients, Lyme borreliosis Immunofluorescence assay (IFA), Lyme borreliosis diagnosis 98, 99 Incidence, see Epidemiology Israeli spotted fever, features 145, 146 Ixodes ricinus borreliosis transmission 2, geographic distribution 19 life cycle Latitude, Lyme borreliosis influences 36, 37 Lichen sclerosus et atrophicus, clinical findings 67, 68 Lumbar puncture, see Lyme neuroborreliosis Lyme arthritis antibiotic therapy clinical characteristics diagnosis 89 differential diagnosis 90 etiology 84 frequency 83, 84 histologic findings 85 natural evolution 193 pathogenesis 84, 85 persistent disease management polymerase chain reaction analysis 193, 194 treatment 193 Lyme carditis antibiotic therapy 122 clinical characteristics 76, 77 diagnosis 77, 78 differential diagnosis 78 etiology 75 frequency 75 histology 76 tick bite history 75 Lyme neuroborreliosis (LNB) antibiotic therapy clinical characteristics early disease 72, 73 late disease 73 clinical presentation 201 diagnosis 73, 74, 96, 97, 202, 203 differential diagnosis 75, 204 etiology 69, 70 frequency 70, 71 histology 71, 72 lumbar puncture cerebrospinal fluid findings 96, 97, 100, 203, 204 indications 201, 202 repeat puncture 205 natural evolution persistent disease management 196 tick bite history 71 Lymphocytoma, borrelial antibiotic therapy 121 biopsy 81 clinical characteristics 60, 61, 81 definition 59 diagnosis 61, 62 differential diagnosis 62 etiology 59 frequency 59 Lymphoma, see Cutaneous lymphoma 210 Subject Index

4 Mediterranean spotted fever, features 146 Methotrexate, Lyme arthritis management Morphea, see Scleroderma circumscripta Multilocus sequence typing (MLST), Borrelia burgdorferi sensu lato complex diversity analysis 3 Myositis, Lyme borreliosis 93 Neuroborreliosis, see Lyme neuroborreliosis Nodular fasciitis, Lyme borreliosis 93 Occupation, Lyme borreliosis risks 44, 50 OspA, pathogenicity factor 4, 5 OspC, pathogenicity factor 5, 12, 13 Osteomyelitis, Lyme borreliosis 93 Panniculitis, Lyme borreliosis 93 Polymerase chain reaction (PCR), Borrelia burgdorferi sensu lato complex diversity analysis 3 anaplasmosis 133 babesiosis 143 Lyme arthritis analysis 193, 194 Lyme borreliosis diagnosis 97, 98 tularemia 139 Pregnancy Lyme borreliosis antibiotic therapy clinical presentation 184, 185 course 183, 184 fetal effects 184 ticks antibiotic prophylaxis 185, 186 detection and removal 185 follow-up of bite 186 tick testing 185 P66, pathogenicity factor 4 Rickettsiosis Rickettsia aeschlimannii 148, 149 Rickettsia conorii complex 144 Rickettsia conorii subsp. caspia 146 Rickettsia conorii subsp. conorii 144, 145 Rickettsia conorii subsp. israelensis 145, 146 Rickettsia helvetica 149, 150 Rickettsia massilae 149 Rickettsia raoulti 150 Rickettsia sibirica subsp. mongolitimonae 146, 147 Rickettsia slovaca 147, 148 treatment 150 Scleroderma circumscripta, clinical findings 67, 68 Seasonal distribution, Lyme borreliosis 38 Serology, see Antibody serology Sex differences, Lyme borreliosis incidence 39, 40, 44 Subjective symptoms management 196, 197 natural evolution 196 Sulfasalazine, Lyme arthritis management Surveillance, Lyme borreliosis 44, 45 Synovectomy, Lyme arthritis management 194, Tick-borne encephalitis (TBE) clinical presentation 141 diagnosis 138, 139 epidemiology 140 pathogen 140 risk assessment 159 treatment 139 Tick-borne relapsing fever (TBRF) clinical presentation 135 diagnosis 136 epidemiology 134, 135 pathogens 134 transmission 134, 135 treatment 136 vectors 134 Ticks, see also Ixodes ricinus analysis of removed ticks 162 bites local reactions 159, 160 management 162, 163 prevention 123, 124, 162 prophylaxis after bites 126, 127 risks 156, 158 diseases, see specific diseases pregnant patients antibiotic prophylaxis 185, 186 detection and removal 185 follow-up of bite 186 tick testing 185 Subject Index 211

5 Ticks, see also Ixodes ricinus (continued) removal 123, 124, 160, 161 repellents 123 vectors, agents, and diseases 131, 155, 156 Transplant patients, Lyme borreliosis 96 Tularemia clinical presentation 137, 138 diagnosis 141 epidemiology 137 pathogen 136, 137 treatment 141 Weather, Lyme borreliosis influence 40, 41 Western blot, Lyme borreliosis diagnosis diagnostic value 173, 174 interpretation 175, 176 line immunoblot 172 overview 169, 170 recombinant immunoblot 171 stage-dependent antibody kinetics 172, 173 whole cell antigen immunoblot 170, 171 Vaccines, Lyme disease 126 VlsE, pathogenicity factor Subject Index