Response: Commentary: Borrelia miyamotoi : 43 Cases Diagnosed in France by Real-Time PCR in Patients With Persistent Polymorphic Signs and Symptoms

Frontiers in Medicine

article

Michel Franck¹  Raouf Ghozzi²  Julie Pajaud¹  Nadou E. Lawson-Hogban¹  Marie Mas³  Alexis Lacout⁴  Christian Perronne⁵ 

[1] ADNucleis;Hôpital de Lannemezan;Clinique Convert, Médecine Générale, Service des Urgences;Centre de diagnostic ELSAN, Centre Médico - Chirurgical;Hôpital Universitaire Raymond Poincaré (Assistance Publique – Hópitaux de Paris), Département d'Infectiologie, Université de Versailles – Saint Quentin

关键词: Borrelia;    Borrelia miyamotoi;    Lyme;    post treatment Lyme disease syndrome;    persistent polymorphic syndrome possibly due to a tick bite;   

DOI  :  10.3389/fmed.2020.586694

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Wagemakers et al. pretend that the population is not sufficiently characterized. Our patients were seen in consultation (outpatient in private practice), by doctors trained in the diagnosis of SPPT (Persistent polymorphic syndrome possibly due to a tick bite), and PCR tests were performed when they met the precise definition of SPPT. The SPPT officially recognized in France by the High Authority for Health (HAS) is, however, precisely defined by a clinical triad associating several times a week, for more than 6 months, with exclusion of other possible co-morbidities (neoplasia or some auto-immune disorders, for example): a polyalgic syndrome (musculoskeletal pain and/or neuropathic pain and/or headaches); persistent fatigue with reduced physical capacities; cognitive complaints; a possible history of tick bite (2). Our questionnaire included the items published in a reference cited in the article (3). We acknowledge that although other possible diagnoses have been formally excluded, these could have been collected more systematically. The difference between SPPT and PTLDS (Post Treatment Lyme Disease Syndrome) is that a diagnosis of Lyme disease has not been proven, principally because the efficiency of Lyme serology lacks sensitivity, which is established by several publications (4, 5). We agree that the problem is certainly more complex, as patients are often poly-infected and therefore borreliosis (including B. miyamotoi) probably represents the tip of an iceberg. SPPT patients (unlike PTLDS) also may have not been treated.

【 授权许可】

CC BY