Neuroinfekce stručný úvod.Neuroinfekce – staronová výzva pro neurologii. A nejen pro ni •...

Neuroinfekce ndash stručnyacute uacutevod

M Bojar Univerzita Karlova v Praze

2 leacutekařskaacute

fakulta Neurologickaacute

klinika FN Motol

Praha

Neuroinfekce

ndash

staronovaacute

vyacutezva pro neurologii A nejen pro ni

bull

Uacutevod ndash

historickeacute

poznaacutemkybull

Epidemiologickaacute

data o některyacutech

neuroinfekciacutech

ndash

Neuroinfekce

Všedniacuteho

Dnebull

Infekčniacute

agens ndash

běžnaacute

i vzaacutecnaacute opomiacutejenaacute

bull

Mezioborovaacute

problematika Kam s niacutem Labelbull

Kdy pomyacutešlet na možnou neuroinfekci Dg

bull

Leacutečbabull

Proč

a v čem chybujeme

Hippocrates

z Koacutesu ndash

proslavil se opatřeniacutemi proti epidemii průjmovyacutech onemocněniacute

v Atheacutenaacutech

Aesklepion

ndash

moderniacute

koncept prevence hygiena balneotherapiehellip

3

Errare humanum esthellipbull

Why

should

we

teach

them

facts when

they

can

Google ETA manifest 03 2013bull

Proč

se chybuje Neuroinfekce

-

over-

or

under-

diagnosed

bull

Proč

se zneužiacutevaacute

některyacutech diagnoacutez bull

Kdo se maacute

o pacienty bdquostaratldquo

bull

Infekce neurologie interna bull

Staronoveacute

nemoci infekce mediaacutelniacute

a PR tlaky (BSE CFS Lb

HIV)bull

Kam s niacutem (probleacutemovyacutem naacuteročnyacutem a rizikovyacutem pacientem)

bull

Prvniacute

pravidlo praktickeacute

mediciacuteny

Kde je to nahnuteacute jen s tiacutem pryč jen s tiacutem honem pryč

ACronin

Bojar

M LB dgthrehKonSPLPrg280208 5

Nemociacute ktereacute

působeniacutem mikrobů

vznikajiacute

jest s pravděpodobnostiacute

velkou počet velikyacutehellip

J Thomayer 1893

bull

Anaplasma

phagocytophylumbull

Campylobacter

pyl et

jejuni

bull

Herpetickeacute

viry‐

HSV 123 CMVEBV6‐8

bull

HIVbull

Chlamydie

bull

Chřipkabull

Leptospiry

bull

Mycoplasma

pneumoniaebull

Mykotickeacute

infekce

bull

Prionybull

Spirochety

‐

Borrelia

b Treponema

pal

bull

Toxoplasma

g parazitoacutezybull

Viry neurotropndash

arborviry

‐

MEK

enteroviry spalničky

Tropher

whip

BorrelieHVS

SpirochetyECM

ACA

Trophe

whip VZV

Galantniacute

nemoci a jejich bdquopřiacutenosldquo pro neurologii a psychiatrii

bull

Syphilis

ndash španělskaacute

či francouzskaacute

nemoc

bull

HIV

‐

AIDS

bull

HSV‐2

bull

Chlamydie

bull

Papilomavirus

bull

Hepatitis B a C

MBojar Borrelioacuteza Nahaacuteč28042010 7MBojar Borrelioacuteza Nahaacuteč28042010 7

The name syphilis was coined by Hieronymus Fracastorius

who

published in 1530 the poem Syphilis sive

morbus

gallicus (Syphilis or the

French Disease) in which the name of the disease first appeared Perhaps more importantly Fracastorius

went on in 1546

to write On

Contagion (De contagione

et contagiosis

morbis

et curatione) the first known discussion of the phenomenon of contagious

infection

Bojar M Chronickaacute

neuroborrelioacuteza HnM

0509

7

Vektor

Borrel

Treponema

px

Treppx

88

Treponema

pallidum

a Borrelia

burgd garinii infekčniacute

agens -

postiženiacute

NS a dalšiacutech orgaacutenů

bull

P Virchow

bull

P Virchow

byl odpůrcem teorie o patogenniacutem vlivu infekčniacutech agens jako přiacutečiny řady chorobhellip

8

bull

1870 ndash

objev pathog Mikroorganismůhellip

9

J Thomayer

ndash

Pathologie a therapie nemociacute vnitřniacutech Oddiacutel Prvniacute Nemoci celkoveacute původu

infekčniacuteho Praha 1893

bull Nemociacute ktereacute takovyacutemto působeniacutem mikrobů vznikajiacute jest

s pravděpodobnostiacute velkou počet velikyacute

avšak jen v maleacutem počtu


J Thomayer

ndash

Pathologie a therapie

nemociacute vnitřniacutech

Oddiacutel Prvniacute Nemoci celkoveacute

původu


bull

podařilo se již

choroboplodneacute mikroby žaacutedouciacutem způsobem zjistit

Jak se měnil pohled na neuroinfekce Errare humanumhellipbull

Progresivniacute

paralyacuteza neuritis multiplex obrna liacutecniacuteho

nervu ndash

internista prof Thomayer

bull

Obrna liacutecniacuteho nervundash

neurolog prof Henner

bull

Herpes genitofemoralis

ndash

dermatovenerolog

prof Tryacuteb

bull

Erythema

migrans acrodermatitis

chronica

‐

dermatovenerolog

prof Tryacuteb

bull

GBS ‐

neurolog RAC Hughes

1212

Progresivniacute

paralyacuteza pronaacutesleduje lidstvo od nepaměti

hellip

12J Thomayer 1893

13

Zaacutenět nervů

jednotlivyacutechNeuritis simplex J Thomayer Pathologie a therapie

nemociacute

vnitřniacutech 1893

bull

Obrny po difteriibull

Neuralgie nervu trojklanneacuteho

bull

Obrna nervu liacutecniacutehobull

Mimickaacute

křeč

bull

Nemoc Menierovabull

Neuralgie nervů

zaacutehlavniacutech

bull

Neuralgie pleteni pažniacutebull

Mezižeberniacute

neuralgie Neuralgie n sedaciacuteho

14

Obrna nervu liacutecniacuteho ndash

prosopoplegia Ch Bell 1838 JThomayer 1893 KHenner

1951

bull

JTh-

bdquovšeobecně

se uvaacutediacute nachlazeniacuteldquo ale jest domněnka

o rheumat původu

Takovaacuteto domněle rheumatickaacute paralysa nastupuje

nejčastěji mezi 20-40 rldquo

15

Bellova

obrna

ndash

idiopatickaacute

obrna liacutecniacuteho nervu Ničeho netřeba tu podnikatihellip

bull

ProfK Henner

- bdquotzv samostatnaacute reumatickaacute

obrna

časteacute

nepochybneacute refrigeračniacute

momenty

bull

Tzv

fokaacutelniacute

infekcebull

Teacutež

postih vasa

nervor

ndash

persistujiacuteciacute

spasmus při chladuldquo

16

Herpetviry ndash

postiženiacute

NS Herpes progenitalis

ATryacuteb

-

Praktickaacute

dermatologie

Praha 1941

bull

Zdůrazňuji toliko že progenitaacutelniacute

herpes

vyznačujiacuteciacute

se většiacutemi nebo menšiacutemi skupinkami

drobnyacutech puchyacuteřků

17

Herpes progenitalis

ndash ATryacuteb - Praktickaacute dermatologie Praha 1941

bull

vyvstaacutevaacute

zhusta po prudkeacutem sexuaacutelniacutem

podraacutežděniacute při němž

nedošlo k souloži

nějakaacute

kontagiosniacute

infekce virem cestou genitaacutelniacute

je tedy

vyloučena

18

Tu a tam přichaacutezejiacute

lideacute

s podivnyacutem erytheacutemem ATryacuteb Praktickaacute

dermatologie 1941

s174

bull obyčejně nafialovělyacutem několik mm silnyacutem kruhem

různeacute velikosti kteryacute se pravidelně odstředivě rozšiřuje od určiteacuteho

bodu

19

Může byacutet vůbec tento nevyacuteznamnyacute fenomeacuten nazyacutevaacuten nemociacute

bull

Dosaacutehne nezřiacutedka průměru i půl mbull

Silneacute

ozaacuteřeniacute

sluncem

až

se kůže sloupe zpravidla proces zastaviacute

Tryacuteb

s 174

2020


bull Therapeuticky

netřeba tu nic podnikati

neb kruhjak se zvětšuje tak bledne

až

znenaacutehla vymiziacute bez nejmenšiacutech potiacutežiacute

Tryacuteb

s 174

21

RAC Hughes

ndash

Guillain-Barreacute

Syndrome

The multiplicity of agents which may trigger GBS 1990

bull

bdquo Předchoziacute

infekce HV je patrně

vyacuteznamnyacutem faktorem

spouštějiacuteciacutem GB syldquo

-

CMV EBV HZ HSV

bull

Vakcinace ndash

praseči chřipka kravskeacute

neštovice proti vzteklině

bull

Dalšiacute

možnaacute agens ndash1990 bull

Mycoplasma

pneumoniae Campylobacter

jejunihellip

bull

Po 23 l bull

Pokrok se zastavit nedaacute ndash AIDP CIDP

22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)

Eseje 1580 O empatii

bull

Ti ostatniacute

naacutes vedou asi jako ten kdo maluje moře uacutetesy a přiacutestavy ale sediacute

u stolu a v bezpečiacute

si nechaacute

předvaacutedět model lodi Postavte ho do skutečneacuteho života a nebude vědět co maacute

dělat

bull

Leacutekaři popisujiacute

naše bolesti takovyacutem způsobem jako městskyacute trubač

oznamuje zaběhleacute

koně

nebo psy takovou maacute srst tak je velkyacute takoveacute

maacute

uši

a když

mu toho koně

nebo psa ukaacutežete nepoznaacute

je

bull

Je jen spraacutevneacute aby se leacutekaři nakazili přiacutejiciacute když

ji chtějiacute

leacutečit Opravdu takoveacutemu leacutekaři bych se svěřil

22

22

Treponema pallidum a Borrelia burgdorferi garini afzelii

bull

Treponema

pallidum byla popsaacutena v r 1905

německyacutem bakteriologem Fritzem

Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema

(niť přiacuteze) s latinskyacutem pallida

(bledaacute) doslovně

obracejiacuteciacute

se světlaacute nitka

bull

Borrelia

burgdorferi

byla popsaacutena v USA v r 1981

švyacutecarskyacutem

bakteriologem W Burgdorferem

v tkaacuteniacutech

osob s Lyme

disease kterou znovuobjevil 1975 Steere

u

dětskeacute

juvenil sezoacutenniacute polyartritidy

v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy

a neuroborrelioacutezy

ndash

i Postborrelioveacuteho

sy

(Pbs)

bull

Časnaacute

infekce cca 6000rokbull

lokalizovanaacute

ECM ndash

50

bull

diseminovanaacutendash

bdquoviroacutezaldquo pneumonie

ndash

monopolyartritis

( gonitis omalgie) 20-30

ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash

(peri)-myokarditis 1-2

bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute

artritida artropatiebull

encefalomyelopatie MS-likeldquo

bull

kognitiv

dysf depresivsy pseudoneurast

sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull

Neuroborrelioacuteza

chronPbs

10 ze všech Nb 150-250 rok

Kolik pacientů s LB vidiacute 1 PL

bull

Počet leacutekařeků všeobecneacute

praktickeacute

leacutekařstviacute

5211bull

Počet leacutekařeků

praktickeacute


pro děti a dorost 2121

bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull

Incidence borrelioacutezy 4 -

8 000rok v ČR

bull

Incidence KME500-700 rok

bull

Incidence Ehrlichiosy

desiacutetkyrok


data nejsou přesnaacute přesto je nutno o nich uvažovathellip

26

27

Co rozhoduje o odeslaacuteniacute

pac při susp inf či parainf on CNSNS

bull

Odborneacute

- mediciacutenskeacuteorganizačniacute

ekonomickeacute

a psychol sociaacutelniacute

důvody

bull

Jakyacute model je uacutečelnyacutebull

Co chtějiacute

infektologoveacute

co bdquoneinfektologoveacuteldquobull

Co prospiacutevaacute

pacientům

bull

Co na to plaacutetci (ZP)

28

Jakeacute

projevy neuroinfekciacute

a jakeacute

syndromy převlaacutedajiacute

bull

Cefalea

+ meningeaacutelniacute

sy

‐

meningitis meningoencefalitismeningoencefalomyelit

‐

df dg SAK expproces (Ab) systeacutem onbull

Fokaacutelcelkoveacute

syHNT sy

‐

encefalitis Ab

bull

Obrny poruchy čitiacute mikce

‐

myelitis polyradiculoneuritis neuritis

bull

PO VII poruchy zraku sluchu zaacutevrať‐ rhombencefalitis neuritis cranialis

29

Nejčastějšiacute

diagnoacutezy ndashsusp neuroinfekce afekce CNSNS u pac odeslanyacutech na Neu

kliniku FNMbull

Dopor PL special a neurology na ambul vyš

bull

PO NVII kran neurbull

Lym

bor ndash

susp i chr

bull

Susp mening iritacebull

Herpes zost-ak i PZN

bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull

Meningeaacutelsy vyloučit KME

bull

meningoencefalitis

suspbull

Alterace vědomiacute

bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull

Radiculitis myelitis

bull

Radikulaacuterniacute

sy

diskogenniacutebull

Polyradiculoneuritis

-

GB sy

30

Diagnostickyacute postup u osob se susp neuroinfekciacute parainfekčniacutem

onemocněniacutem NS

bull

Susp meningoencef encefalAb neuroinf

bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP

- vyšSM baktervirol

kult serol a PCRbull

Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull

Susp polyradiculone myelitis neuritis (cran)

bull

RtgCT MRIbull

Kompl lab vč LP

-

vyšSM baktervirol kult serol a PCR

bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute

inf agens u infekčniacutech parainfekčniacutech chorob

CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull

Adenoviry Rhinovirybull

HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull

CysticerkoacutezaEchinokokbull

Mykoacutezy -

kandidoacuteza

kryptokokoacuteza aspergiloacuteza

bull

Bakteriebull

Spirochety

-

Lyme Lu

bull

Stafylostrepto-kokybull

Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull

Enterobakterkokybull

MycobactTb Leptospiry Listerie

Jak leacutečit neuroinfekce Neprodleně kauzaacutelně dostatečně komplexně

Atb antivirotika antimykotika (kortikoidy)bull

CAVE ndash akutniacute

potenciaacutelně

letaacutelniacute průběhy

bull

ME purulentniacute

ndash

koky haemoph kortiko+CEP

bull

ME listeriebull

ME herpetickaacute

ndashACV

bull

ME kliacutešťovaacute

ndash antiedematozniacute

leacutečba

bull

ME mykotickaacute

bull

ME ndash akutniacutebull

Seroacutezniacute aseptickeacute

ndash

bull

Viroveacutebull

Postvakcinačniacute

bull

Borrelie Anaplasma phagocyt rickettsie

franciscella

tularensis leptospiry

bull

Tetanus botulismus rabies

33

Symptomat a komplex leacutečba pac S neuroinfekcemi

Anxieta deprese bolesti uacutenavahellip

Symptomatika

ndashbull

analgetika NSA vaacutezoaktiva steroidy

bull

antidepresiva SSRI ndash

fluoxetin citalopram Neuromodulancia BZD hypnotika

bull

Dieta vitaminy potrav doplňky Chondroprotektiva

bull

Rhb fysioterapie balneoterapie Behavioraacutelniacute

th Psychoterapie

Jak leacutečit perzistujiacuteciacute() infekce neuroinfekce

bull

Řada postinfekčniacutech

parainfekčniacutech

chronicko

ndash progredientniacutech multiorgaacutenovyacutech

afekciacute

s

autoimunitniacute

a psychosomatickou

složkou (dysfunkce diencefala hipokampu)

bull

CF syndrome ndash chronickaacute uacutenava ndashpseudoneurasten sy Epstein

Barreacute

vx

neuro‐ hepato‐ pantropniacute

agens

bull

Hroziacute

polypragmaacutezie

i terapeutickyacute nihilismus

34

35

Jak to tedy vlastně

s chronickou neuroinf chronickou neuroborreliosou Pbs

je

bull

10-20 pac -

projevy chronickeacuteho zaacutenětliveacuteho onemocněniacute

s možnou persistenciacute

infekčniacuteho

agens Duaacutelniacute

infekce ndash

herpet Viry chlamydie hellip

bull

Je-li pozit průkaz borreliiacute

ndash

PCR ELM dynamika protilaacutetek ve WB ndash

jak se vyvarovat opakovaacuteniacute

Wirchovovy

chybybull

Paacutetrat i po dalšiacutech agens Běžnyacutech i vzaacutecnyacutech Tropheryma

whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J

Rheumatol 1994 Mar21(3)454-61Links

OBJECTIVE To determine

chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester

County NY who fulfilled

Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our

examination RESULTS Erythema

migrans

had occurred

in 70 of

patients neurological

involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and

arthritis in 41 Patients

were

seen

at

a mean

of

32 years

after

initial

treatment A history of

relapse

with

major organ involvement

had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia

antibodies initially

present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int

J Med Microbiol 2006

May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme

borreliosis eg musculoskeletal

or radicular

pain dysaesthesia and

neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics

in these patients but

recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme

neuroborreliosis J Neuroinflammation 2008 Sep

25540 BACKGROUND The

long

latent

stage

seen

in syphilis followed

by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and

intracellular pleomorphic

and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme

neuroborreliosis The persistence of

these more resistant

spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38


Neuroinfekce ndash staronovaacute vyacutezva pro neurologii A nejen pro ni

Sniacutemek čiacuteslo 3

Errare humanum esthellip


Galantniacute nemoci a jejich bdquopřiacutenosldquo pro neurologii a psychiatrii





Jak se měnil pohled na neuroinfekce Errare humanumhellip





















Jak leacutečit neuroinfekceNeprodleně kauzaacutelně dostatečně komplexně Atb antivirotika antimykotika (kortikoidy)







Neuroinfekce

ndash

staronovaacute

vyacutezva pro neurologii A nejen pro ni

bull

Uacutevod ndash

historickeacute

poznaacutemkybull


data o některyacutech

neuroinfekciacutech

ndash

Neuroinfekce

Všedniacuteho

Dnebull

Infekčniacute

agens ndash

běžnaacute

i vzaacutecnaacute opomiacutejenaacute

bull

Mezioborovaacute

problematika Kam s niacutem Labelbull

Kdy pomyacutešlet na možnou neuroinfekci Dg

bull

Leacutečbabull

Proč

a v čem chybujeme

Hippocrates

z Koacutesu ndash



Aesklepion

ndash

moderniacute


3


Why

should

we

teach

them

facts when

they

can


Proč


-

over-

or

under-

diagnosed

bull

Proč



Kdo se maacute


bull


Staronoveacute



HIV)bull


bull

Prvniacute


mediciacuteny


ACronin

Bojar




vznikajiacute



J Thomayer 1893

bull

Anaplasma

phagocytophylumbull

Campylobacter

pyl et

jejuni

bull

Herpetickeacute

viry‐

HSV 123 CMVEBV6‐8

bull

HIVbull

Chlamydie

bull

Chřipkabull

Leptospiry

bull

Mycoplasma

pneumoniaebull

Mykotickeacute

infekce

bull

Prionybull

Spirochety

‐

Borrelia

b Treponema

pal

bull

Toxoplasma


Viry neurotropndash

arborviry

‐

MEK


Tropher

whip

BorrelieHVS

SpirochetyECM

ACA

Trophe

whip VZV

Galantniacute


bull

Syphilis



nemoc

bull

HIV

‐

AIDS

bull

HSV‐2

bull

Chlamydie

bull

Papilomavirus

bull

Hepatitis B a C



who


morbus



went on in 1546

to write On


et contagiosis

morbis


infection



0509

7

Vektor

Borrel

Treponema

px

Treppx

88

Treponema

pallidum

a Borrelia


agens -

postiženiacute


bull

P Virchow

bull

P Virchow


8

bull

1870 ndash


9

J Thomayer

ndash







J Thomayer

ndash




původu


bull

podařilo se již



Progresivniacute


nervu ndash


bull



bull


ndash

dermatovenerolog

prof Tryacuteb

bull

Erythema


chronica

‐

dermatovenerolog

prof Tryacuteb

bull

GBS ‐

neurolog RAC Hughes

1212

Progresivniacute


hellip

12J Thomayer 1893

13

Zaacutenět nervů


nemociacute


bull



bull


Mimickaacute

křeč

bull

Nemoc Menierovabull

Neuralgie nervů


bull


Mezižeberniacute


14



1951

bull

JTh-

bdquovšeobecně


o rheumat původu



15

Bellova

obrna

ndash

idiopatickaacute


bull

ProfK Henner


obrna

časteacute


momenty

bull

Tzv

fokaacutelniacute

infekcebull

Teacutež

postih vasa

nervor

ndash



16

Herpetviry ndash

postiženiacute


ATryacuteb

-

Praktickaacute

dermatologie

Praha 1941

bull


herpes




17

Herpes progenitalis


bull

vyvstaacutevaacute



nedošlo k souloži

nějakaacute

kontagiosniacute


je tedy

vyloučena

18


lideacute


dermatologie 1941

s174



bodu

19


bull


Silneacute

ozaacuteřeniacute

sluncem

až


Tryacuteb

s 174

2020


bull Therapeuticky



až


Tryacuteb

s 174

21

RAC Hughes

ndash

Guillain-Barreacute

Syndrome


bull





-

CMV EBV HZ HSV

bull

Vakcinace ndash



bull

Dalšiacute


Mycoplasma


jejunihellip

bull

Po 23 l bull


22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)


bull

Ti ostatniacute



si nechaacute


dělat

bull




koně


maacute

uši

a když

mu toho koně


je

bull


ji chtějiacute


22

22


bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































Hippocrates

z Koacutesu ndash



Aesklepion

ndash

moderniacute


3


Why

should

we

teach

them

facts when

they

can


Proč


-

over-

or

under-

diagnosed

bull

Proč



Kdo se maacute


bull


Staronoveacute



HIV)bull


bull

Prvniacute


mediciacuteny


ACronin

Bojar




vznikajiacute



J Thomayer 1893

bull

Anaplasma

phagocytophylumbull

Campylobacter

pyl et

jejuni

bull

Herpetickeacute

viry‐

HSV 123 CMVEBV6‐8

bull

HIVbull

Chlamydie

bull

Chřipkabull

Leptospiry

bull

Mycoplasma

pneumoniaebull

Mykotickeacute

infekce

bull

Prionybull

Spirochety

‐

Borrelia

b Treponema

pal

bull

Toxoplasma


Viry neurotropndash

arborviry

‐

MEK


Tropher

whip

BorrelieHVS

SpirochetyECM

ACA

Trophe

whip VZV

Galantniacute


bull

Syphilis



nemoc

bull

HIV

‐

AIDS

bull

HSV‐2

bull

Chlamydie

bull

Papilomavirus

bull

Hepatitis B a C



who


morbus



went on in 1546

to write On


et contagiosis

morbis


infection



0509

7

Vektor

Borrel

Treponema

px

Treppx

88

Treponema

pallidum

a Borrelia


agens -

postiženiacute


bull

P Virchow

bull

P Virchow


8

bull

1870 ndash


9

J Thomayer

ndash







J Thomayer

ndash




původu


bull

podařilo se již



Progresivniacute


nervu ndash


bull



bull


ndash

dermatovenerolog

prof Tryacuteb

bull

Erythema


chronica

‐

dermatovenerolog

prof Tryacuteb

bull

GBS ‐

neurolog RAC Hughes

1212

Progresivniacute


hellip

12J Thomayer 1893

13

Zaacutenět nervů


nemociacute


bull



bull


Mimickaacute

křeč

bull

Nemoc Menierovabull

Neuralgie nervů


bull


Mezižeberniacute


14



1951

bull

JTh-

bdquovšeobecně


o rheumat původu



15

Bellova

obrna

ndash

idiopatickaacute


bull

ProfK Henner


obrna

časteacute


momenty

bull

Tzv

fokaacutelniacute

infekcebull

Teacutež

postih vasa

nervor

ndash



16

Herpetviry ndash

postiženiacute


ATryacuteb

-

Praktickaacute

dermatologie

Praha 1941

bull


herpes




17

Herpes progenitalis


bull

vyvstaacutevaacute



nedošlo k souloži

nějakaacute

kontagiosniacute


je tedy

vyloučena

18


lideacute


dermatologie 1941

s174



bodu

19


bull


Silneacute

ozaacuteřeniacute

sluncem

až


Tryacuteb

s 174

2020


bull Therapeuticky



až


Tryacuteb

s 174

21

RAC Hughes

ndash

Guillain-Barreacute

Syndrome


bull





-

CMV EBV HZ HSV

bull

Vakcinace ndash



bull

Dalšiacute


Mycoplasma


jejunihellip

bull

Po 23 l bull


22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)


bull

Ti ostatniacute



si nechaacute


dělat

bull




koně


maacute

uši

a když

mu toho koně


je

bull


ji chtějiacute


22

22


bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38








































Why

should

we

teach

them

facts when

they

can


Proč


-

over-

or

under-

diagnosed

bull

Proč



Kdo se maacute


bull


Staronoveacute



HIV)bull


bull

Prvniacute


mediciacuteny


ACronin

Bojar




vznikajiacute



J Thomayer 1893

bull

Anaplasma

phagocytophylumbull

Campylobacter

pyl et

jejuni

bull

Herpetickeacute

viry‐

HSV 123 CMVEBV6‐8

bull

HIVbull

Chlamydie

bull

Chřipkabull

Leptospiry

bull

Mycoplasma

pneumoniaebull

Mykotickeacute

infekce

bull

Prionybull

Spirochety

‐

Borrelia

b Treponema

pal

bull

Toxoplasma


Viry neurotropndash

arborviry

‐

MEK


Tropher

whip

BorrelieHVS

SpirochetyECM

ACA

Trophe

whip VZV

Galantniacute


bull

Syphilis



nemoc

bull

HIV

‐

AIDS

bull

HSV‐2

bull

Chlamydie

bull

Papilomavirus

bull

Hepatitis B a C



who


morbus



went on in 1546

to write On


et contagiosis

morbis


infection



0509

7

Vektor

Borrel

Treponema

px

Treppx

88

Treponema

pallidum

a Borrelia


agens -

postiženiacute


bull

P Virchow

bull

P Virchow


8

bull

1870 ndash


9

J Thomayer

ndash







J Thomayer

ndash




původu


bull

podařilo se již



Progresivniacute


nervu ndash


bull



bull


ndash

dermatovenerolog

prof Tryacuteb

bull

Erythema


chronica

‐

dermatovenerolog

prof Tryacuteb

bull

GBS ‐

neurolog RAC Hughes

1212

Progresivniacute


hellip

12J Thomayer 1893

13

Zaacutenět nervů


nemociacute


bull



bull


Mimickaacute

křeč

bull

Nemoc Menierovabull

Neuralgie nervů


bull


Mezižeberniacute


14



1951

bull

JTh-

bdquovšeobecně


o rheumat původu



15

Bellova

obrna

ndash

idiopatickaacute


bull

ProfK Henner


obrna

časteacute


momenty

bull

Tzv

fokaacutelniacute

infekcebull

Teacutež

postih vasa

nervor

ndash



16

Herpetviry ndash

postiženiacute


ATryacuteb

-

Praktickaacute

dermatologie

Praha 1941

bull


herpes




17

Herpes progenitalis


bull

vyvstaacutevaacute



nedošlo k souloži

nějakaacute

kontagiosniacute


je tedy

vyloučena

18


lideacute


dermatologie 1941

s174



bodu

19


bull


Silneacute

ozaacuteřeniacute

sluncem

až


Tryacuteb

s 174

2020


bull Therapeuticky



až


Tryacuteb

s 174

21

RAC Hughes

ndash

Guillain-Barreacute

Syndrome


bull





-

CMV EBV HZ HSV

bull

Vakcinace ndash



bull

Dalšiacute


Mycoplasma


jejunihellip

bull

Po 23 l bull


22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)


bull

Ti ostatniacute



si nechaacute


dělat

bull




koně


maacute

uši

a když

mu toho koně


je

bull


ji chtějiacute


22

22


bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































Bojar




vznikajiacute



J Thomayer 1893

bull

Anaplasma

phagocytophylumbull

Campylobacter

pyl et

jejuni

bull

Herpetickeacute

viry‐

HSV 123 CMVEBV6‐8

bull

HIVbull

Chlamydie

bull

Chřipkabull

Leptospiry

bull

Mycoplasma

pneumoniaebull

Mykotickeacute

infekce

bull

Prionybull

Spirochety

‐

Borrelia

b Treponema

pal

bull

Toxoplasma


Viry neurotropndash

arborviry

‐

MEK


Tropher

whip

BorrelieHVS

SpirochetyECM

ACA

Trophe

whip VZV

Galantniacute


bull

Syphilis



nemoc

bull

HIV

‐

AIDS

bull

HSV‐2

bull

Chlamydie

bull

Papilomavirus

bull

Hepatitis B a C



who


morbus



went on in 1546

to write On


et contagiosis

morbis


infection



0509

7

Vektor

Borrel

Treponema

px

Treppx

88

Treponema

pallidum

a Borrelia


agens -

postiženiacute


bull

P Virchow

bull

P Virchow


8

bull

1870 ndash


9

J Thomayer

ndash







J Thomayer

ndash




původu


bull

podařilo se již



Progresivniacute


nervu ndash


bull



bull


ndash

dermatovenerolog

prof Tryacuteb

bull

Erythema


chronica

‐

dermatovenerolog

prof Tryacuteb

bull

GBS ‐

neurolog RAC Hughes

1212

Progresivniacute


hellip

12J Thomayer 1893

13

Zaacutenět nervů


nemociacute


bull



bull


Mimickaacute

křeč

bull

Nemoc Menierovabull

Neuralgie nervů


bull


Mezižeberniacute


14



1951

bull

JTh-

bdquovšeobecně


o rheumat původu



15

Bellova

obrna

ndash

idiopatickaacute


bull

ProfK Henner


obrna

časteacute


momenty

bull

Tzv

fokaacutelniacute

infekcebull

Teacutež

postih vasa

nervor

ndash



16

Herpetviry ndash

postiženiacute


ATryacuteb

-

Praktickaacute

dermatologie

Praha 1941

bull


herpes




17

Herpes progenitalis


bull

vyvstaacutevaacute



nedošlo k souloži

nějakaacute

kontagiosniacute


je tedy

vyloučena

18


lideacute


dermatologie 1941

s174



bodu

19


bull


Silneacute

ozaacuteřeniacute

sluncem

až


Tryacuteb

s 174

2020


bull Therapeuticky



až


Tryacuteb

s 174

21

RAC Hughes

ndash

Guillain-Barreacute

Syndrome


bull





-

CMV EBV HZ HSV

bull

Vakcinace ndash



bull

Dalšiacute


Mycoplasma


jejunihellip

bull

Po 23 l bull


22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)


bull

Ti ostatniacute



si nechaacute


dělat

bull




koně


maacute

uši

a když

mu toho koně


je

bull


ji chtějiacute


22

22


bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































Galantniacute


bull

Syphilis



nemoc

bull

HIV

‐

AIDS

bull

HSV‐2

bull

Chlamydie

bull

Papilomavirus

bull

Hepatitis B a C



who


morbus



went on in 1546

to write On


et contagiosis

morbis


infection



0509

7

Vektor

Borrel

Treponema

px

Treppx

88

Treponema

pallidum

a Borrelia


agens -

postiženiacute


bull

P Virchow

bull

P Virchow


8

bull

1870 ndash


9

J Thomayer

ndash







J Thomayer

ndash




původu


bull

podařilo se již



Progresivniacute


nervu ndash


bull



bull


ndash

dermatovenerolog

prof Tryacuteb

bull

Erythema


chronica

‐

dermatovenerolog

prof Tryacuteb

bull

GBS ‐

neurolog RAC Hughes

1212

Progresivniacute


hellip

12J Thomayer 1893

13

Zaacutenět nervů


nemociacute


bull



bull


Mimickaacute

křeč

bull

Nemoc Menierovabull

Neuralgie nervů


bull


Mezižeberniacute


14



1951

bull

JTh-

bdquovšeobecně


o rheumat původu



15

Bellova

obrna

ndash

idiopatickaacute


bull

ProfK Henner


obrna

časteacute


momenty

bull

Tzv

fokaacutelniacute

infekcebull

Teacutež

postih vasa

nervor

ndash



16

Herpetviry ndash

postiženiacute


ATryacuteb

-

Praktickaacute

dermatologie

Praha 1941

bull


herpes




17

Herpes progenitalis


bull

vyvstaacutevaacute



nedošlo k souloži

nějakaacute

kontagiosniacute


je tedy

vyloučena

18


lideacute


dermatologie 1941

s174



bodu

19


bull


Silneacute

ozaacuteřeniacute

sluncem

až


Tryacuteb

s 174

2020


bull Therapeuticky



až


Tryacuteb

s 174

21

RAC Hughes

ndash

Guillain-Barreacute

Syndrome


bull





-

CMV EBV HZ HSV

bull

Vakcinace ndash



bull

Dalšiacute


Mycoplasma


jejunihellip

bull

Po 23 l bull


22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)


bull

Ti ostatniacute



si nechaacute


dělat

bull




koně


maacute

uši

a když

mu toho koně


je

bull


ji chtějiacute


22

22


bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38









































who


morbus



went on in 1546

to write On


et contagiosis

morbis


infection



0509

7

Vektor

Borrel

Treponema

px

Treppx

88

Treponema

pallidum

a Borrelia


agens -

postiženiacute


bull

P Virchow

bull

P Virchow


8

bull

1870 ndash


9

J Thomayer

ndash







J Thomayer

ndash




původu


bull

podařilo se již



Progresivniacute


nervu ndash


bull



bull


ndash

dermatovenerolog

prof Tryacuteb

bull

Erythema


chronica

‐

dermatovenerolog

prof Tryacuteb

bull

GBS ‐

neurolog RAC Hughes

1212

Progresivniacute


hellip

12J Thomayer 1893

13

Zaacutenět nervů


nemociacute


bull



bull


Mimickaacute

křeč

bull

Nemoc Menierovabull

Neuralgie nervů


bull


Mezižeberniacute


14



1951

bull

JTh-

bdquovšeobecně


o rheumat původu



15

Bellova

obrna

ndash

idiopatickaacute


bull

ProfK Henner


obrna

časteacute


momenty

bull

Tzv

fokaacutelniacute

infekcebull

Teacutež

postih vasa

nervor

ndash



16

Herpetviry ndash

postiženiacute


ATryacuteb

-

Praktickaacute

dermatologie

Praha 1941

bull


herpes




17

Herpes progenitalis


bull

vyvstaacutevaacute



nedošlo k souloži

nějakaacute

kontagiosniacute


je tedy

vyloučena

18


lideacute


dermatologie 1941

s174



bodu

19


bull


Silneacute

ozaacuteřeniacute

sluncem

až


Tryacuteb

s 174

2020


bull Therapeuticky



až


Tryacuteb

s 174

21

RAC Hughes

ndash

Guillain-Barreacute

Syndrome


bull





-

CMV EBV HZ HSV

bull

Vakcinace ndash



bull

Dalšiacute


Mycoplasma


jejunihellip

bull

Po 23 l bull


22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)


bull

Ti ostatniacute



si nechaacute


dělat

bull




koně


maacute

uši

a když

mu toho koně


je

bull


ji chtějiacute


22

22


bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































88

Treponema

pallidum

a Borrelia


agens -

postiženiacute


bull

P Virchow

bull

P Virchow


8

bull

1870 ndash


9

J Thomayer

ndash







J Thomayer

ndash




původu


bull

podařilo se již



Progresivniacute


nervu ndash


bull



bull


ndash

dermatovenerolog

prof Tryacuteb

bull

Erythema


chronica

‐

dermatovenerolog

prof Tryacuteb

bull

GBS ‐

neurolog RAC Hughes

1212

Progresivniacute


hellip

12J Thomayer 1893

13

Zaacutenět nervů


nemociacute


bull



bull


Mimickaacute

křeč

bull

Nemoc Menierovabull

Neuralgie nervů


bull


Mezižeberniacute


14



1951

bull

JTh-

bdquovšeobecně


o rheumat původu



15

Bellova

obrna

ndash

idiopatickaacute


bull

ProfK Henner


obrna

časteacute


momenty

bull

Tzv

fokaacutelniacute

infekcebull

Teacutež

postih vasa

nervor

ndash



16

Herpetviry ndash

postiženiacute


ATryacuteb

-

Praktickaacute

dermatologie

Praha 1941

bull


herpes




17

Herpes progenitalis


bull

vyvstaacutevaacute



nedošlo k souloži

nějakaacute

kontagiosniacute


je tedy

vyloučena

18


lideacute


dermatologie 1941

s174



bodu

19


bull


Silneacute

ozaacuteřeniacute

sluncem

až


Tryacuteb

s 174

2020


bull Therapeuticky



až


Tryacuteb

s 174

21

RAC Hughes

ndash

Guillain-Barreacute

Syndrome


bull





-

CMV EBV HZ HSV

bull

Vakcinace ndash



bull

Dalšiacute


Mycoplasma


jejunihellip

bull

Po 23 l bull


22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)


bull

Ti ostatniacute



si nechaacute


dělat

bull




koně


maacute

uši

a když

mu toho koně


je

bull


ji chtějiacute


22

22


bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































9

J Thomayer

ndash







J Thomayer

ndash




původu


bull

podařilo se již



Progresivniacute


nervu ndash


bull



bull


ndash

dermatovenerolog

prof Tryacuteb

bull

Erythema


chronica

‐

dermatovenerolog

prof Tryacuteb

bull

GBS ‐

neurolog RAC Hughes

1212

Progresivniacute


hellip

12J Thomayer 1893

13

Zaacutenět nervů


nemociacute


bull



bull


Mimickaacute

křeč

bull

Nemoc Menierovabull

Neuralgie nervů


bull


Mezižeberniacute


14



1951

bull

JTh-

bdquovšeobecně


o rheumat původu



15

Bellova

obrna

ndash

idiopatickaacute


bull

ProfK Henner


obrna

časteacute


momenty

bull

Tzv

fokaacutelniacute

infekcebull

Teacutež

postih vasa

nervor

ndash



16

Herpetviry ndash

postiženiacute


ATryacuteb

-

Praktickaacute

dermatologie

Praha 1941

bull


herpes




17

Herpes progenitalis


bull

vyvstaacutevaacute



nedošlo k souloži

nějakaacute

kontagiosniacute


je tedy

vyloučena

18


lideacute


dermatologie 1941

s174



bodu

19


bull


Silneacute

ozaacuteřeniacute

sluncem

až


Tryacuteb

s 174

2020


bull Therapeuticky



až


Tryacuteb

s 174

21

RAC Hughes

ndash

Guillain-Barreacute

Syndrome


bull





-

CMV EBV HZ HSV

bull

Vakcinace ndash



bull

Dalšiacute


Mycoplasma


jejunihellip

bull

Po 23 l bull


22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)


bull

Ti ostatniacute



si nechaacute


dělat

bull




koně


maacute

uši

a když

mu toho koně


je

bull


ji chtějiacute


22

22


bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38








































J Thomayer

ndash




původu


bull

podařilo se již



Progresivniacute


nervu ndash


bull



bull


ndash

dermatovenerolog

prof Tryacuteb

bull

Erythema


chronica

‐

dermatovenerolog

prof Tryacuteb

bull

GBS ‐

neurolog RAC Hughes

1212

Progresivniacute


hellip

12J Thomayer 1893

13

Zaacutenět nervů


nemociacute


bull



bull


Mimickaacute

křeč

bull

Nemoc Menierovabull

Neuralgie nervů


bull


Mezižeberniacute


14



1951

bull

JTh-

bdquovšeobecně


o rheumat původu



15

Bellova

obrna

ndash

idiopatickaacute


bull

ProfK Henner


obrna

časteacute


momenty

bull

Tzv

fokaacutelniacute

infekcebull

Teacutež

postih vasa

nervor

ndash



16

Herpetviry ndash

postiženiacute


ATryacuteb

-

Praktickaacute

dermatologie

Praha 1941

bull


herpes




17

Herpes progenitalis


bull

vyvstaacutevaacute



nedošlo k souloži

nějakaacute

kontagiosniacute


je tedy

vyloučena

18


lideacute


dermatologie 1941

s174



bodu

19


bull


Silneacute

ozaacuteřeniacute

sluncem

až


Tryacuteb

s 174

2020


bull Therapeuticky



až


Tryacuteb

s 174

21

RAC Hughes

ndash

Guillain-Barreacute

Syndrome


bull





-

CMV EBV HZ HSV

bull

Vakcinace ndash



bull

Dalšiacute


Mycoplasma


jejunihellip

bull

Po 23 l bull


22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)


bull

Ti ostatniacute



si nechaacute


dělat

bull




koně


maacute

uši

a když

mu toho koně


je

bull


ji chtějiacute


22

22


bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38








































Progresivniacute


nervu ndash


bull



bull


ndash

dermatovenerolog

prof Tryacuteb

bull

Erythema


chronica

‐

dermatovenerolog

prof Tryacuteb

bull

GBS ‐

neurolog RAC Hughes

1212

Progresivniacute


hellip

12J Thomayer 1893

13

Zaacutenět nervů


nemociacute


bull



bull


Mimickaacute

křeč

bull

Nemoc Menierovabull

Neuralgie nervů


bull


Mezižeberniacute


14



1951

bull

JTh-

bdquovšeobecně


o rheumat původu



15

Bellova

obrna

ndash

idiopatickaacute


bull

ProfK Henner


obrna

časteacute


momenty

bull

Tzv

fokaacutelniacute

infekcebull

Teacutež

postih vasa

nervor

ndash



16

Herpetviry ndash

postiženiacute


ATryacuteb

-

Praktickaacute

dermatologie

Praha 1941

bull


herpes




17

Herpes progenitalis


bull

vyvstaacutevaacute



nedošlo k souloži

nějakaacute

kontagiosniacute


je tedy

vyloučena

18


lideacute


dermatologie 1941

s174



bodu

19


bull


Silneacute

ozaacuteřeniacute

sluncem

až


Tryacuteb

s 174

2020


bull Therapeuticky



až


Tryacuteb

s 174

21

RAC Hughes

ndash

Guillain-Barreacute

Syndrome


bull





-

CMV EBV HZ HSV

bull

Vakcinace ndash



bull

Dalšiacute


Mycoplasma


jejunihellip

bull

Po 23 l bull


22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)


bull

Ti ostatniacute



si nechaacute


dělat

bull




koně


maacute

uši

a když

mu toho koně


je

bull


ji chtějiacute


22

22


bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































1212

Progresivniacute


hellip

12J Thomayer 1893

13

Zaacutenět nervů


nemociacute


bull



bull


Mimickaacute

křeč

bull

Nemoc Menierovabull

Neuralgie nervů


bull


Mezižeberniacute


14



1951

bull

JTh-

bdquovšeobecně


o rheumat původu



15

Bellova

obrna

ndash

idiopatickaacute


bull

ProfK Henner


obrna

časteacute


momenty

bull

Tzv

fokaacutelniacute

infekcebull

Teacutež

postih vasa

nervor

ndash



16

Herpetviry ndash

postiženiacute


ATryacuteb

-

Praktickaacute

dermatologie

Praha 1941

bull


herpes




17

Herpes progenitalis


bull

vyvstaacutevaacute



nedošlo k souloži

nějakaacute

kontagiosniacute


je tedy

vyloučena

18


lideacute


dermatologie 1941

s174



bodu

19


bull


Silneacute

ozaacuteřeniacute

sluncem

až


Tryacuteb

s 174

2020


bull Therapeuticky



až


Tryacuteb

s 174

21

RAC Hughes

ndash

Guillain-Barreacute

Syndrome


bull





-

CMV EBV HZ HSV

bull

Vakcinace ndash



bull

Dalšiacute


Mycoplasma


jejunihellip

bull

Po 23 l bull


22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)


bull

Ti ostatniacute



si nechaacute


dělat

bull




koně


maacute

uši

a když

mu toho koně


je

bull


ji chtějiacute


22

22


bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































13

Zaacutenět nervů


nemociacute


bull



bull


Mimickaacute

křeč

bull

Nemoc Menierovabull

Neuralgie nervů


bull


Mezižeberniacute


14



1951

bull

JTh-

bdquovšeobecně


o rheumat původu



15

Bellova

obrna

ndash

idiopatickaacute


bull

ProfK Henner


obrna

časteacute


momenty

bull

Tzv

fokaacutelniacute

infekcebull

Teacutež

postih vasa

nervor

ndash



16

Herpetviry ndash

postiženiacute


ATryacuteb

-

Praktickaacute

dermatologie

Praha 1941

bull


herpes




17

Herpes progenitalis


bull

vyvstaacutevaacute



nedošlo k souloži

nějakaacute

kontagiosniacute


je tedy

vyloučena

18


lideacute


dermatologie 1941

s174



bodu

19


bull


Silneacute

ozaacuteřeniacute

sluncem

až


Tryacuteb

s 174

2020


bull Therapeuticky



až


Tryacuteb

s 174

21

RAC Hughes

ndash

Guillain-Barreacute

Syndrome


bull





-

CMV EBV HZ HSV

bull

Vakcinace ndash



bull

Dalšiacute


Mycoplasma


jejunihellip

bull

Po 23 l bull


22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)


bull

Ti ostatniacute



si nechaacute


dělat

bull




koně


maacute

uši

a když

mu toho koně


je

bull


ji chtějiacute


22

22


bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































14



1951

bull

JTh-

bdquovšeobecně


o rheumat původu



15

Bellova

obrna

ndash

idiopatickaacute


bull

ProfK Henner


obrna

časteacute


momenty

bull

Tzv

fokaacutelniacute

infekcebull

Teacutež

postih vasa

nervor

ndash



16

Herpetviry ndash

postiženiacute


ATryacuteb

-

Praktickaacute

dermatologie

Praha 1941

bull


herpes




17

Herpes progenitalis


bull

vyvstaacutevaacute



nedošlo k souloži

nějakaacute

kontagiosniacute


je tedy

vyloučena

18


lideacute


dermatologie 1941

s174



bodu

19


bull


Silneacute

ozaacuteřeniacute

sluncem

až


Tryacuteb

s 174

2020


bull Therapeuticky



až


Tryacuteb

s 174

21

RAC Hughes

ndash

Guillain-Barreacute

Syndrome


bull





-

CMV EBV HZ HSV

bull

Vakcinace ndash



bull

Dalšiacute


Mycoplasma


jejunihellip

bull

Po 23 l bull


22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)


bull

Ti ostatniacute



si nechaacute


dělat

bull




koně


maacute

uši

a když

mu toho koně


je

bull


ji chtějiacute


22

22


bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































15

Bellova

obrna

ndash

idiopatickaacute


bull

ProfK Henner


obrna

časteacute


momenty

bull

Tzv

fokaacutelniacute

infekcebull

Teacutež

postih vasa

nervor

ndash



16

Herpetviry ndash

postiženiacute


ATryacuteb

-

Praktickaacute

dermatologie

Praha 1941

bull


herpes




17

Herpes progenitalis


bull

vyvstaacutevaacute



nedošlo k souloži

nějakaacute

kontagiosniacute


je tedy

vyloučena

18


lideacute


dermatologie 1941

s174



bodu

19


bull


Silneacute

ozaacuteřeniacute

sluncem

až


Tryacuteb

s 174

2020


bull Therapeuticky



až


Tryacuteb

s 174

21

RAC Hughes

ndash

Guillain-Barreacute

Syndrome


bull





-

CMV EBV HZ HSV

bull

Vakcinace ndash



bull

Dalšiacute


Mycoplasma


jejunihellip

bull

Po 23 l bull


22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)


bull

Ti ostatniacute



si nechaacute


dělat

bull




koně


maacute

uši

a když

mu toho koně


je

bull


ji chtějiacute


22

22


bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































16

Herpetviry ndash

postiženiacute


ATryacuteb

-

Praktickaacute

dermatologie

Praha 1941

bull


herpes




17

Herpes progenitalis


bull

vyvstaacutevaacute



nedošlo k souloži

nějakaacute

kontagiosniacute


je tedy

vyloučena

18


lideacute


dermatologie 1941

s174



bodu

19


bull


Silneacute

ozaacuteřeniacute

sluncem

až


Tryacuteb

s 174

2020


bull Therapeuticky



až


Tryacuteb

s 174

21

RAC Hughes

ndash

Guillain-Barreacute

Syndrome


bull





-

CMV EBV HZ HSV

bull

Vakcinace ndash



bull

Dalšiacute


Mycoplasma


jejunihellip

bull

Po 23 l bull


22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)


bull

Ti ostatniacute



si nechaacute


dělat

bull




koně


maacute

uši

a když

mu toho koně


je

bull


ji chtějiacute


22

22


bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































17

Herpes progenitalis


bull

vyvstaacutevaacute



nedošlo k souloži

nějakaacute

kontagiosniacute


je tedy

vyloučena

18


lideacute


dermatologie 1941

s174



bodu

19


bull


Silneacute

ozaacuteřeniacute

sluncem

až


Tryacuteb

s 174

2020


bull Therapeuticky



až


Tryacuteb

s 174

21

RAC Hughes

ndash

Guillain-Barreacute

Syndrome


bull





-

CMV EBV HZ HSV

bull

Vakcinace ndash



bull

Dalšiacute


Mycoplasma


jejunihellip

bull

Po 23 l bull


22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)


bull

Ti ostatniacute



si nechaacute


dělat

bull




koně


maacute

uši

a když

mu toho koně


je

bull


ji chtějiacute


22

22


bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































18


lideacute


dermatologie 1941

s174



bodu

19


bull


Silneacute

ozaacuteřeniacute

sluncem

až


Tryacuteb

s 174

2020


bull Therapeuticky



až


Tryacuteb

s 174

21

RAC Hughes

ndash

Guillain-Barreacute

Syndrome


bull





-

CMV EBV HZ HSV

bull

Vakcinace ndash



bull

Dalšiacute


Mycoplasma


jejunihellip

bull

Po 23 l bull


22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)


bull

Ti ostatniacute



si nechaacute


dělat

bull




koně


maacute

uši

a když

mu toho koně


je

bull


ji chtějiacute


22

22


bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































19


bull


Silneacute

ozaacuteřeniacute

sluncem

až


Tryacuteb

s 174

2020


bull Therapeuticky



až


Tryacuteb

s 174

21

RAC Hughes

ndash

Guillain-Barreacute

Syndrome


bull





-

CMV EBV HZ HSV

bull

Vakcinace ndash



bull

Dalšiacute


Mycoplasma


jejunihellip

bull

Po 23 l bull


22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)


bull

Ti ostatniacute



si nechaacute


dělat

bull




koně


maacute

uši

a když

mu toho koně


je

bull


ji chtějiacute


22

22


bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































2020


bull Therapeuticky



až


Tryacuteb

s 174

21

RAC Hughes

ndash

Guillain-Barreacute

Syndrome


bull





-

CMV EBV HZ HSV

bull

Vakcinace ndash



bull

Dalšiacute


Mycoplasma


jejunihellip

bull

Po 23 l bull


22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)


bull

Ti ostatniacute



si nechaacute


dělat

bull




koně


maacute

uši

a když

mu toho koně


je

bull


ji chtějiacute


22

22


bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































21

RAC Hughes

ndash

Guillain-Barreacute

Syndrome


bull





-

CMV EBV HZ HSV

bull

Vakcinace ndash



bull

Dalšiacute


Mycoplasma


jejunihellip

bull

Po 23 l bull


22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)


bull

Ti ostatniacute



si nechaacute


dělat

bull




koně


maacute

uši

a když

mu toho koně


je

bull


ji chtějiacute


22

22


bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































22

Michel

Eyquem de Montaigne

(282 1553ndash

239 1592)


bull

Ti ostatniacute



si nechaacute


dělat

bull




koně


maacute

uši

a když

mu toho koně


je

bull


ji chtějiacute


22

22


bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38








































bull

Treponema



Schaudinnem

(1871-1906)bull

Spojil řeckeacute

trepo

(

obraciacutem se)

a nema





bull

Borrelia

burgdorferi




v tkaacuteniacutech

osob s Lyme


u

dětskeacute


v Maasachussets

23

24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































24

25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































25

Epidemiologie Lyme

borrelioacutezy


ndash


sy

(Pbs)

bull

Časnaacute


lokalizovanaacute

ECM ndash

50

bull



ndash

monopolyartritis


ndash

ME Banwarthův

sy KrNn- PO NVII

30 2000rok

ndash


bull

Pozdniacute

infekcebull

ACA

s neuromyopat sy

bull

chronickaacute



bull

kognitiv


sy-

CFS

bull

Expy sybull

ALS sy

bull

myasthensybull

Neuroradikulopatie

bull


chronPbs



bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38








































bull


praktickeacute


5211bull


praktickeacute



bull

Počet neurologů

1410bull

Počet dermatologů

841

bull

Počet infektologů

130

bull


8 000rok v ČR

bull


bull


desiacutetkyrok



26

27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































27



bull

Odborneacute


ekonomickeacute


důvody

bull


Co chtějiacute

infektologoveacute



pacientům

bull


28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































28

Jakeacute


a jakeacute


bull

Cefalea


sy

‐


‐



syHNT sy

‐

encefalitis Ab

bull


‐


bull


29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































29

Nejčastějšiacute


kliniku FNMbull


bull


Lym

bor ndash

susp i chr

bull



bull

Herpetickaacute

inf-

HV 12 -

5 (CFS sy)

bull

Odeslaacuteniacute

ad hospitbull


bull

meningoencefalitis

suspbull


bull

Ložiskoveacute

projevy -

jako TIA CMP Epi

bull

Lyme

borrelioacuteza

ndash

Bannwarth

sybull


bull


sy

diskogenniacutebull


-

GB sy

30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































30



bull


bull

CT event

s klbull

MRI -

roste vyacuteznam

bull

Kompl lab vč LP



Konzil-

infthepplic

bull

EEG EP-

VEP BAEP

bull


bull

RtgCT MRIbull

Kompl lab vč LP

-


bull

EMG SSEP MEPbull

Konzil-

infthepplic

31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































31

Nejčastějšiacute


CNSNS na Neu

klinice FNM

bull

Virybull

HV 123 4-6

bull

Enterovirybull

Virus KME

bull


HIV

bull

Paraziteacutebull

Toxoplasmoacuteza

bull


Mykoacutezy -

kandidoacuteza


bull

Bakteriebull

Spirochety

-

Lyme Lu

bull


Meningopneumokoky

bull

Haemophilus

inflbull

Pseudomonas

aer

bull






potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38










































potenciaacutelně


bull

ME purulentniacute

ndash


bull

ME listeriebull

ME herpetickaacute

ndashACV

bull



leacutečba

bull

ME mykotickaacute

bull



ndash

bull

Viroveacutebull


bull


franciscella


bull


33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































33



Symptomatika

ndashbull


bull



bull


bull


th Psychoterapie


bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38








































bull



chronicko


afekciacute

s

autoimunitniacute

a psychosomatickou


bull


Barreacute

vx


agens

bull

Hroziacute

polypragmaacutezie


34

35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































35



je

bull

10-20 pac -



infekčniacuteho


infekce ndash


bull


ndash



Wirchovovy

chybybull


whipplei

a prionovaacute

onemocněniacute

36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































36

Asch

ES Bujak

DI Weiss M Peterson

MG Weinstein

A Lyme

disease an

infectious

and

postinfectious

syndrome J



chronic

morbidity and

the

variables

that

influence recovery

in patients

who

had been

treated

for

Lyme

disease METHODS

Retrospective

evaluation

of

215

patients

from

Westchester


Centers

for

Disease

Control

case

definition

for

Lyme

disease were

anti-

Borrelia

antibody

positive and

were

diagnosed

and

treated

at

least

one

year

before our


migrans

had occurred

in 70 of


involvement

in 29 objective

cardiac problems

in 6 arthralgia

in 78 and


were

seen

at

a mean

of

32 years

after

initial


relapse

with


had occurred

in 28

and

a history

of

reinfection

in 18 Anti-Borrelia


present

in all

patients were

still

positive in 32

37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































37

Pfister

HW Rupprecht

TA

Clinical

aspects

of

neuroborreliosis

and post-Lyme

disease

syndrome in adult

patients Int


May296 Suppl

4011-6

bull

Post-Lyme

disease

(PLD) syndrome is

characterized

by persistent

complaints

and

symptoms

after

previous

treatment

for

Lyme


or radicular


neurocognitive

symptoms

that

are often

associated

with

fatigue bull

No formal

definition

of

the

PLD syndrome and

its

pathogenesis

is

unclear Recent

controlled

studies

do not support the

use of

additional

antibiotics


recommend

primarily

symptomatic

strategies

37

Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































Miklossy

J Kasas

S Zurn

AD McCall

S Yu

S McGeer

PL Persisting

atypical and

cystic

forms

of

Borrelia

burgdorferi

and

local

inflammation

in

Lyme



long

latent

stage

seen


by chronic

central nervous

system

infection

and

inflammation can

be

explained

by the

persistence of

atypical

cystic

and

granular

forms

of

Treponema

pallidum We

investigated

whether a similar

situation

may

occur

in Lyme

neuroborreliosis

CONCLUSION The

results

indicate

that

atypical

extra-

and


and

cystic

forms

of

Borrelia

burgdorferi

and

local

neuroinflammation

occur

in the

brain

in chronic

Lyme



spirochete

forms and

their

intracellular

location

in neurons

and

glial

cells may

explain

the

long

latent

stage

and persistence of

Borrelia

infection The

results

also

suggest

that

Borrelia

burgdorferi

may

induce

cellular

dysfunction

and

apoptosis The

detection

and recognition

of

atypical cystic

and

granular

forms

in infected

tissues

is

essential

for

the

diagnosis

and

the

treatment

as they

can

occur

in the

absence of

the

typical spiral

Borrelia

form

38







































Neuroinfekce stručný úvod.Neuroinfekce – staronová výzva pro neurologii. A nejen pro ni •...

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Transcript of Neuroinfekce stručný úvod.Neuroinfekce – staronová výzva pro neurologii. A nejen pro ni •...