Borreliose

ZUSAMMENFASSUNG

Die Lyme-Borreliose mit sehr unterschiedlichen Krankheitsmanifestationen wird durch verschiedene Erreger des Genus Borrelia verursacht. Borrelien werden (in Deutschland) durch die Schildzecke Ixodes ricinus übertragen. Einblicke in die Pathophysiologie erlauben ein besseres Verständnis von Krankheitsmanifestation, Diagnostik und Therapie der Borreliose. Abhängig vom jeweiligen Erreger (Spezies und Genotyp) können sich die Bakterien lokal vermehren oder auch in unterschiedliche Organe verteilen. Durch verschiedene Mechanismen entziehen sich Borrelien dem Zugriff durch unser Immunsystem, was zu einer starken jedoch ineffizienten Immunantwort führen kann. Die Symptome werden fast ausschließlich durch diese Immunantwort verursacht, was die Lyme-Borreliose zu einer wichtigen Differenzialdiagnose in der Rheumatologie macht. Neben der Klinik, Diagnostik und Therapie der Lyme-Borreliose befasst sich dieser Beitrag mit der Pathophysiologie, was über ein besseres Verstehen der Erkrankung zu Fehlervermeidung im klinischen Alltag führen dürfte.

ABSTRACT

Lyme disease is caused by different bacterial species of the genus borrelia resulting in an infection with a plethora of different symptoms. The disease vector, in Germany, is the tick Ixodes ricinus. Knowledge of the pathophysiology of Lyme disease can help explain the clinical manifestations, diagnosis, and therapy of Lyme disease. Whether Lyme disease remains a local infection in the skin, or spreads to different organs, depends heavily on the species and genotype of the infecting bacteria. Borrelia can evade the immune system due to a multitude of strategies; this can result in a strong, however, inefficient response by the immune system. The symptoms of Lyme disease are almost exclusively caused by this errant immune response. As a result, Lyme disease is an important differential diagnosis for the field of rheumatology. This article describes not only the clinical manifestations, diagnosis, and treatment of Lyme disease, but also the pathophysiology. With this better understanding of the pathophysiology common errors in the diagnosis and treatment of Lyme disease can be prevented.

Schlüsselwörter

Lyme-Borreliose - Lyme-Arthritis - Antibiotika-refraktäre Lyme-Arthritis

Keywords

Lyme disease - Lyme arthritis - antibiotic-refractary Lyme arthritis

Publikationsverlauf

Artikel online veröffentlicht:
19. April 2022

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