Huk M. Optimization of diagnosis and therapy of Lyme borreliosis and human granulocytic anaplasmosis

Optimization of diagnosis and therapy of Lyme borreliosis (LB) and human granulocytic anaplasmosis (HGA) according to the clinical and epidemiological features of their course and results of laboratory and instrumental examination is studied in this thesis. Thermographic criteria for the course of EF LB have been suggested, in particular for evaluation of treatment efficacy. A clinical evaluation for IIFT (BIOCIP technology) in serological diagnosis for searching for other infections in LB and HGA patients with arthritis and enlarged lymph nodes has been performed. A rational scheme of complex treatment of patients with combined LB and HGA, which involves a sequential administration of ceftriaxone and doxycycline hydrochloride in combination with lyophilized Saccharomyces boulardii CNCM I-745 and Silybi mariani fructus extractum siccum, was substantiated. The efficacy of complex therapy for LB and HGA patients was evaluated by the dynamics of joint damage (according to DAS 28) and the levels of cytokines (IL-6 and TNF-α) in the serum of patients. The epidemiological and clinical features of tick-borne infections (LB and HGA) were complemented. It was proved that among patients with NEF LB and in combination with HGA, the majority were those who had a single tick attack in the forest belt/woods rather than in parks or homesteads (p < 0.05). Clinical manifestations of NEF LB, combined NEF LB and HGA, and HGA only were studied. The part of seropositive individuals (31.3 %) for B. burgdorferi s. l. and clinical manifestations of LB was defined using a two-step serological diagnostic scheme (enzyme-linked immunosorbent assay – ELISA and immunoblot). Combined NEF LB and HGA was revealed in 35.4 % of patients. HGA only by PCR and IIFT was diagnosed in 33.3 % of patients.