Diagnose und Therapie der Lyme-Borreliose – alles unklar, alles schlecht?

ZUSAMMENFASSUNG

Die durch wenigstens fünf Borrelia (B.) burgdorferi-Arten verursachte Lyme-Borreliose ist die häufigste durch Zecken übertragene Erkrankung in Europa und den USA. Die nur bei entsprechenden Symptomen indizierte mikrobiologische Diagnostik basiert auf dem Nachweis spezifischer Antikörper aus Serum und ggf. Liquor. Nur bei unklaren Fällen sollen PCR und Anzucht aus Hautbiopsie, Liquor oder Gelenkpunktat eingesetzt werden. Für die orale Therapie stehen Amoxicillin, Doxycyclin, Cefuroxim und Azithromycin zur Verfügung, für die i. v. Therapie Cefotaxim, Ceftriaxon und Penicillin G. Eingesetztes Antibiotikum und Dauer der Therapie – 10–30 Tage – orientieren sich an der Manifestation, Schwere der Erkrankung und individueller Verträglichkeit. Die Prognose der therapierten Lyme-Borreliose ist insgesamt als gut einzuschätzen, Defektheilungen sind selbst nach länger bestehenden Erkrankungen im Kindesalter selten.

ABSTRACT

Lyme borreliosis, caused by at least five Borrelia (B.) burgdorferi species, is the most common tick-borne disease in Europe and the USA. The microbiological diagnosis, indicated only in the case of corresponding symptoms, is based on the detection of specific antibodies from serum and possibly liquor. PCR and culture from skin biopsy, liquor or joint puncture should only be used in unclear cases. For oral therapy, amoxicillin, doxycycline, cefuroxime and azithromycin are available, for i. v. therapy cefotaxime, ceftriaxone and penicillin G. The antibiotic used and duration of therapy – 10–30 days – is based on the manifestation, severity of the disease and individual tolerance. The prognosis of treated Lyme borreliosis is overall to be assessed as good, defect healing is rare even after long-term illnesses in childhood.

Schlüsselwörter

Lyme-Borreliose - Diagnostik - Therapie

Keywords

Lyme borreliosis - diagnostic - therapy

Publication History

Article published online:
22 June 2022

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