Clinical and epidemiological characteristics of tick-borne borreliosis in the Krasnodar Krai
The purpose of the study the improvement of early diagnostics of Lyme disease on the based of clinical and epidemiological analysis of the main clinical forms of the acute course of the disease in new natural foci in the Krasnodar Krai. Patients and methods. There was analyzed the clinical course of disease and epidemiological data for 207 patients in the early period of acute course of Lyme disease within the period from 2004 to 2013. Results. In the territory of the Krasnodar Krai and the Republic of Adygea there has formed a set of foci of tick-borne borreliosis (TB), i.e. Lyme disease (LD). The infection of cases is observed not only in the natural foci of disease, but also within the city limits. The disease is registered mainly in the erythematous form (74% of patients), non-erythematous form accounts for 26%. The average age of patients was 41,1±1,83, years, males 38%, females 62%. In the non-erythematous form initial clinical symptoms are recorded in average in 11,6 ± 2,20 days after tick suction; in the erythematous form in 6,4 ± 0,70 days ( p <0.05). The greatest difficulties are arised in the diagnosis of the non-erythematous form of TB running with prolonged fever and central nervous system involvement. Initial clinical manifestations of non-erythematous forms are symptoms of meningitis or meningoencephalitis of serous nature, and defeat of the third pair of cranial nerves. In the erythematous form of TB there are observed symptoms of peripheral nervous system damage in the form of radiculopathies. Regardless of the clinical form, in the first month of disease diffuse myocardial changes (55.3%) or conduction disorders of varying severity ( 7.1%) are recorded. Conclusion. In clinical diagnostics of TB distributed in the Krasnodar Krai, the early manifestation of signs of involvement of he nervous and cardiovascular systems must be considered. The formation of new natural foci of TB requires the in-depth clinical and epidemiological study, introduction of the different methods of serological diagnosis (indirect immunofluorescence test, ELISA) and PCR studies.