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DGI:Lymeborreliose/Prophylaxe und Prävention - Revision history
2026-06-11T03:18:43Z
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https://wiki.cakele.iodatalabs.dev/index.php?title=DGI:Lymeborreliose/Prophylaxe_und_Pr%C3%A4vention&diff=1143&oldid=prev
imported>Bestem at 12:43, 15 December 2020
2020-12-15T12:43:24Z
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imported>Bestem
https://wiki.cakele.iodatalabs.dev/index.php?title=DGI:Lymeborreliose/Prophylaxe_und_Pr%C3%A4vention&diff=1142&oldid=prev
imported>Brinkery at 13:42, 10 December 2020
2020-12-10T13:42:34Z
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<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>== Prophylaxe / Prävention ==</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>==Prophylaxe / Prävention==</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><span style="box-sizing: inherit; font-family: Arial, sans-serif;">Autor: Scheidhauer</span></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><span style="box-sizing: inherit; font-family: Arial, sans-serif;">Autor: Scheidhauer</span></div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>=== <span style="box-sizing: inherit; font-family: Arial, sans-serif;">Prävention</span> ===</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>===<span style="box-sizing: inherit; font-family: Arial, sans-serif;">Prävention</span>===</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><span style="box-sizing: inherit; font-family: Arial, sans-serif;">von Zeckenstichen bzw. der Lyme-Borreliose:</span></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><span style="box-sizing: inherit; font-family: Arial, sans-serif;">von Zeckenstichen bzw. der Lyme-Borreliose:</span></div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><span style="box-sizing: inherit; font-family: Arial, sans-serif;">Eine medikamentöse orale Prophylaxe wird nicht empfohlen. Die lokale Anwendung von Azithromycin z.B. in Pflasterform wird kontrovers diskutiert.</span></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><span style="box-sizing: inherit; font-family: Arial, sans-serif;">Eine medikamentöse orale Prophylaxe wird nicht empfohlen. Die lokale Anwendung von Azithromycin z.B. in Pflasterform wird kontrovers diskutiert.</span></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><<del style="font-weight: bold; text-decoration: none;">span style="box-sizing: inherit; font-family: Arial, sans-serif;">Literatur:</span></del></div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><<ins style="font-weight: bold; text-decoration: none;">br </ins>/></div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> </div></td><td colspan="2" class="diff-side-added"></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"><span class="docsum-authors" style="box-sizing: inherit;"><span style="box-sizing: inherit;">Cook MJ.</span></span> [https://pubmed.ncbi.nlm.nih.gov/25565881/ <span style="box-sizing: inherit;">Lyme</span> <span style="box-sizing: inherit;">borreliosis</span>: a review of data on transmission time after tick attachment.] <span style="box-sizing: inherit;"> </span><span class="docsum-journal-citation" style="box-sizing: inherit;">Int J Gen Med. 2014 Dec 19;8:1-8</span></del></div></td><td colspan="2" class="diff-side-added"></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> </div></td><td colspan="2" class="diff-side-added"></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"><span style="box-sizing: inherit; font-family: Arial, sans-serif;">Rahlenbeck S, Fingerle V „Ixodes ricinus Wie man sich vor Zecken schützt“ Deutsches Ärzteblatt Jg. 111 Heft 25 A 1142- A 1143<</del>/<del style="font-weight: bold; text-decoration: none;">span</del>></div></td><td colspan="2" class="diff-side-added"></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> </div></td><td colspan="2" class="diff-side-added"></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"><span style="box-sizing: inherit; font-family: Arial, sans-serif;">AWMF Leitlinie der Deutschen Dermatologischen Gesellschaft AWMF-Register-Nr. 013/044 Klasse: S2k „Kutane Lyme Borreliose“ https://www.awmf.org/uploads/tx_szleitlinien/013-044l_S2k_Kutane_Lyme_Borreliose_2016-05.pdf (letzter Zugriff: )</span></del></div></td><td colspan="2" class="diff-side-added"></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> </div></td><td colspan="2" class="diff-side-added"></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;">Nau R, Christen HJ, Eiffert H „Lyme Disease – Current State of Knowledge“ Dtsch Ärztebl Int 2009; 106(5): 72-82 (Diskussion: https://www.aerzteblatt.de/pdf.asp?id=65524)</del></div></td><td colspan="2" class="diff-side-added"></td></tr>
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imported>Brinkery
https://wiki.cakele.iodatalabs.dev/index.php?title=DGI:Lymeborreliose/Prophylaxe_und_Pr%C3%A4vention&diff=1141&oldid=prev
imported>Brinkery: Die Seite wurde neu angelegt: „== Prophylaxe / Prävention == <span style="box-sizing: inherit; font-family: Arial, sans-serif;">Autor: Scheidhauer</span> <br /> === <span style="box-sizing…“
2020-12-10T13:36:02Z
<p>Die Seite wurde neu angelegt: „== Prophylaxe / Prävention == <span style="box-sizing: inherit; font-family: Arial, sans-serif;">Autor: Scheidhauer</span> <br /> === <span style="box-sizing…“</p>
<p><b>New page</b></p><div>== Prophylaxe / Prävention ==<br />
<span style="box-sizing: inherit; font-family: Arial, sans-serif;">Autor: Scheidhauer</span><br />
<br /><br />
<br />
=== <span style="box-sizing: inherit; font-family: Arial, sans-serif;">Prävention</span> ===<br />
<span style="box-sizing: inherit; font-family: Arial, sans-serif;">von Zeckenstichen bzw. der Lyme-Borreliose:</span><br />
<br />
<span style="box-sizing: inherit; font-family: Arial, sans-serif;">Schutz vor Zeckenstichen bietet bedeckende Kleidung (Hosenbeine in die Socken stecken). Nach Aufenthalten im Freien sollte die Haut und insbesondere bei Kindern der behaarte Kopf untersucht werden. Weiterhin sollten Gelenkbeugen, interdigitale Lokalisationen, der Retroauriculärbereich und Glutealfalten abgesucht werden. Innerhalb von zwölf Stunden nach einem Zeckenstich kommt es nur selten zu einer Infektion, da die Borrelien eine gewisse Zeit benötigen, um aus dem Darm der Zecke in den Wirt zu gelangen.</span> <span style="color: rgb(0, 0, 0)">Eine minimale Zeit für eine Übertragung von Borrelien ist aber nicht definiert. In Tierversuchen lag die Übertragungsrate nach 18 – 24 Stunden zwischen 0 – 50 Prozent. <span style="box-sizing: inherit;"> </span>Je schneller somit die Zecke entfernt wird, umso niedriger ist das Risiko, an Borreliose zu erkranken.</span><br />
<br />
<span style="box-sizing: inherit; font-family: Arial, sans-serif;">Die Zeckensuche sollte auch Haustiere mit einschliessen.</span><br />
<br />
<span style="box-sizing: inherit; font-family: Arial, sans-serif;">Repellentien (z. B. DEET, Icaridin, EBAAP) zeigen eine Wirkung, allerdings ist die Schutzzeit dieser Mittel im Vergleich zum Mückenschutz deutlich kürzer.</span><br />
<br />
<span style="box-sizing: inherit; font-family: Arial, sans-serif;">Wer sich häufig im Freien aufhält, kann auch die Imprägnierung der Kleidung mit einem Insektizid (Langzeit-Pyrethroide) in Betracht ziehen.</span><br />
<br />
<span style="box-sizing: inherit; font-family: Arial, sans-serif;">Zecken, die z.B. von Haustieren abfallen, können durchaus eine gewisse Zeit (ein bis zwei Wochen) in der Wohnung überleben und sich einen neuen Wirt suchen.</span><br />
<br />
<span style="box-sizing: inherit; font-family: Arial, sans-serif;">Eine Impfung steht nicht zur Verfügung. Zur Zeckenentfernung existieren Pinzetten bzw. Zeckenkarten. Nach Zeckenentfernung wird die Nachbeobachtung der Einstichstelle für sechs Wochen empfohlen.</span><br />
<br />
<span style="box-sizing: inherit; font-family: Arial, sans-serif;">Eine medikamentöse orale Prophylaxe wird nicht empfohlen. Die lokale Anwendung von Azithromycin z.B. in Pflasterform wird kontrovers diskutiert.</span><br />
<br />
<span style="box-sizing: inherit; font-family: Arial, sans-serif;">Literatur:</span><br />
<br />
<span class="docsum-authors" style="box-sizing: inherit;"><span style="box-sizing: inherit;">Cook MJ.</span></span> [https://pubmed.ncbi.nlm.nih.gov/25565881/ <span style="box-sizing: inherit;">Lyme</span> <span style="box-sizing: inherit;">borreliosis</span>: a review of data on transmission time after tick attachment.] <span style="box-sizing: inherit;"> </span><span class="docsum-journal-citation" style="box-sizing: inherit;">Int J Gen Med. 2014 Dec 19;8:1-8</span><br />
<br />
<span style="box-sizing: inherit; font-family: Arial, sans-serif;">Rahlenbeck S, Fingerle V „Ixodes ricinus Wie man sich vor Zecken schützt“ Deutsches Ärzteblatt Jg. 111 Heft 25 A 1142- A 1143</span><br />
<br />
<span style="box-sizing: inherit; font-family: Arial, sans-serif;">AWMF Leitlinie der Deutschen Dermatologischen Gesellschaft AWMF-Register-Nr. 013/044 Klasse: S2k „Kutane Lyme Borreliose“ https://www.awmf.org/uploads/tx_szleitlinien/013-044l_S2k_Kutane_Lyme_Borreliose_2016-05.pdf (letzter Zugriff: )</span><br />
<br />
Nau R, Christen HJ, Eiffert H „Lyme Disease – Current State of Knowledge“ Dtsch Ärztebl Int 2009; 106(5): 72-82 (Diskussion: https://www.aerzteblatt.de/pdf.asp?id=65524)<br />
{| class="MsoNormalTable" style="width:729.8pt;" border="1" cellspacing="0" cellpadding="0" align="left" width="973"<br />
| style="background-color:rgb(174, 170, 170);width:85.3pt;" width="114" nowrap="" |<br />
| style="background-color:rgb(174, 170, 170);border-right-width:1pt;border-top-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-top-color:windowtext;border-bottom-color:windowtext;width:77.55pt;" width="103" nowrap="" |<span style="color: black">Auftreten nach Zeckenstich</span><br />
| style="background-color:rgb(174, 170, 170);border-right-width:1pt;border-top-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-top-color:windowtext;border-bottom-color:windowtext;width:113.35pt;" width="151" nowrap="" |<span style="color: black">Indikation für Serologie</span><br />
| style="background-color:rgb(174, 170, 170);border-right-width:1pt;border-top-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-top-color:windowtext;border-bottom-color:windowtext;width:4cm;" width="151" nowrap="" |<span style="color: black">zusätzliche Labortests</span><br />
| style="background-color:rgb(174, 170, 170);border-right-width:1pt;border-top-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-top-color:windowtext;border-bottom-color:windowtext;width:184.25pt;" width="246" nowrap="" |<span style="color: black">Klinik</span><br />
| style="background-color:rgb(174, 170, 170);border-right-width:1pt;border-top-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-top-color:windowtext;border-bottom-color:windowtext;width:155.95pt;" width="208" nowrap="" |<span style="color: black">Therapie</span><br />
|- style="box-sizing: inherit;"<br />
| style="border-left-width:1pt;border-right-width:1pt;border-bottom-width:1pt;border-left-color:windowtext;border-right-color:windowtext;border-bottom-color:windowtext;width:85.3pt;" width="114" nowrap="" |<span style="color: black">Erythema migrans</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:77.55pt;" width="103" |<span style="color: black">3-30 Tage</span><br />
<span style="color: black">(Median 7-10 Tage)</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:113.35pt;" width="151" |<span style="color: black">Serologie nicht indiziert</span><br />
<span style="color: black">(Nullserologie ggf einfrieren für später)</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:4cm;" width="151" |<span style="color: black">Keine</span><br />
<span style="color: black">(klinische Diagnose)</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:184.25pt;" width="246" |<span style="color: black">Randbetontes, nicht erhabenes Erythem mit mind. 5 cm Durchmesser</span><br />
<span style="color: black">zunhemende zentrifugale</span><br />
<br />
<span style="color: black">Ausbreitung</span><br />
<br />
<span style="color: black">sichtbare Zeckeeinstichstelle im Zentrum des Erythems</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:155.95pt;" width="208" |<span style="color: black">Doxycyclin 200 mg q24h p.o.</span><br />
<span style="color: black">für 10-14 d</span><br />
<br />
<span style="color: black">ODER</span><br />
<br />
<span style="color: black">Amoxicillin 1 g q8h p.o.</span><br />
<br />
<span style="color: black">für 14 d</span><br />
|- style="box-sizing: inherit;"<br />
| style="border-left-width:1pt;border-right-width:1pt;border-bottom-width:1pt;border-left-color:windowtext;border-right-color:windowtext;border-bottom-color:windowtext;width:85.3pt;" width="114" nowrap="" |<span style="color: black">Benignes Lymphozytom</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:77.55pt;" width="103" nowrap="" |<span style="color: black">2-10 Monate</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:113.35pt;" width="151" |<span style="color: black">Serologie indiziert</span><br />
<span style="color: black">(Sensitivität 80%)</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:4cm;" width="151" nowrap="" |<span style="color: black">ggf Hautbiopsie</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:184.25pt;" width="246" |<span style="color: black">livid-roter subkutaner Knoten</span><br />
<span style="color: black">oder Plaque</span><br />
<br />
<span style="color: black">Pseudolymphom, solitär,</span><br />
<br />
<span style="color: black">bevorzugt bei Kindern</span><br />
<br />
<span style="color: black">Lokalisation: Ohrläppchen,</span><br />
<br />
<span style="color: black">Mamillen oder</span><br />
<br />
<span style="color: black">Genitalbereich</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:155.95pt;" width="208" |<span style="color: black">Doxycyclin 200 mg q24h p.o.</span><br />
<span style="color: black">für 10-14 d</span><br />
<br />
<span style="color: black">ODER</span><br />
<br />
<span style="color: black">Amoxicillin 1 g q8h p.o.</span><br />
<br />
<span style="color: black">für 14 d</span><br />
|- style="box-sizing: inherit;"<br />
| style="border-left-width:1pt;border-right-width:1pt;border-bottom-width:1pt;border-left-color:windowtext;border-right-color:windowtext;border-bottom-color:windowtext;width:85.3pt;" width="114" nowrap="" |<span style="color: black">Acrodermatitis chronica atrophicans</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:77.55pt;" width="103" nowrap="" |<span style="color: black">6 Monate bis viele Jahre</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:113.35pt;" width="151" |<span style="color: black">Serologie indiziert <span style="box-sizing: inherit;"><span class="Apple-converted-space" style="box-sizing: inherit;"> </span></span></span><br />
<span style="color: black">(Sensitivität 99%)</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:4cm;" width="151" |<span style="color: black">PCR aus der Hautbiopsie</span><br />
<span style="color: black">(Sensitivität 70-80%)</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:184.25pt;" width="246" |<span style="color: black">initial ödematös-infiltratives Stadium (rötlich)</span><br />
<span style="color: black">unbehandelt Übergang in atrophes Stadium (lividrot bis lehmbraun)</span><br />
<br />
<span style="color: black">Assoziation mit peripher Neuropathie in 50%</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:155.95pt;" width="208" |<span style="color: black">Doxycyclin 200 mg q24h p.o.</span><br />
<span style="color: black">für 30 d</span><br />
<br />
<span style="color: black">ODER</span><br />
<br />
<span style="color: black">Amoxicillin 1 g q8h p.o.</span><br />
<br />
<span style="color: black">für 30 d</span><br />
|- style="box-sizing: inherit;"<br />
| style="border-left-width:1pt;border-right-width:1pt;border-bottom-width:1pt;border-left-color:windowtext;border-right-color:windowtext;border-bottom-color:windowtext;width:85.3pt;" width="114" nowrap="" |<span style="color: black">Arthritis</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:77.55pt;" width="103" |<span style="color: black">3 - 6 Monate</span><br />
<span style="color: black">( Spät disseminiertes Satdium)</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:113.35pt;" width="151" |<span style="color: black">Serologie indiziert(Sensitivität > 95%)</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:4cm;" width="151" |<span style="color: black">ggf. PCR aus Gelenspunktat, Synovialbiopsie</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:184.25pt;" width="246" |<span style="color: black">schubweise, häufig schmerzarme Mono / Oligoartritis der großen Gelenke v.a. des Kniegelenkes</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:155.95pt;" width="208" nowrap="" |<span style="color: black">Doxycyclin 200 mg q24h p.o.</span><br />
<span style="color: black">für 30 d</span><br />
<br />
<span style="color: black">ODER</span><br />
<br />
<span style="color: black">Amoxicillin 1 g q8h p.o.</span><br />
<br />
<span style="color: black">für 30 d</span><br />
|- style="box-sizing: inherit;"<br />
| style="border-left-width:1pt;border-right-width:1pt;border-bottom-width:1pt;border-left-color:windowtext;border-right-color:windowtext;border-bottom-color:windowtext;width:85.3pt;" width="114" nowrap="" |<span style="color: black">Karditis</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:77.55pt;" width="103" |<span style="color: black">Wochen bis Monate (früh disseminiertes Stadium)</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:113.35pt;" width="151" |<span style="color: black">Serologie Indiziert ggf. Kontrolle für Titeranstieg / Serokonversion (Sensitivität unklar)</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:4cm;" width="151" |<span style="color: black">ggf. PCR aus Biopsie (Sensitivität unklar)</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:184.25pt;" width="246" |<span style="color: black">Neu aufgetretener, tlw. wechselnder AV Block I.-III. Grades .</span><br />
<span style="color: black">Vorhofflimmern,</span><br />
<br />
<span style="color: black">ventrikuläre Extrasystolen Reizleitungs- oder unspezifische Erregungsrückbildungsstörungen.</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:155.95pt;" width="208" nowrap="" |<span style="color: black">Doxycyclin 200 mg q24h p.o.</span><br />
<span style="color: black">für 21 d</span><br />
<br />
<span style="color: black">ODER</span><br />
<br />
<span style="color: black">Amoxicillin 1 g q8h p.o.</span><br />
<br />
<span style="color: black">für 21 d</span><br />
|- style="box-sizing: inherit;"<br />
| style="border-left-width:1pt;border-right-width:1pt;border-bottom-width:1pt;border-left-color:windowtext;border-right-color:windowtext;border-bottom-color:windowtext;width:85.3pt;" width="114" nowrap="" |<span style="color: black">Frühe Neuroborreliose</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:77.55pt;" width="103" nowrap="" |<span style="color: black">Wochen bis Monate</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:113.35pt;" width="151" |<span style="color: black">Serologie indiziert</span><br />
<span style="color: black">im Serum und Liquor,</span><br />
<br />
<span style="color: black">zu Beginn ggf im Serum noch negativ</span><br />
<br />
<span style="color: black">(Sensitivität 70-90%)</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:4cm;" width="151" |<span style="color: black">Liquorpunktion:</span><br />
<span style="color: black">typisch lymphozytäre</span><br />
<br />
<span style="color: black">Liquorpleozytose,</span><br />
<br />
<span style="color: black">positiver Reiber-Quotient</span><br />
<br />
<span style="color: black">ggf PCR</span><br />
<br />
<span style="color: black">(Sensitivität 30%)</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:184.25pt;" width="246" |<span style="color: black">Meningo-Radikuloneuritis</span><br />
<span style="color: black">(Spinal-/Hirnnerven II-XII)</span><br />
<br />
<span style="color: black">mit/ohne Fazialisparese,</span><br />
<br />
<span style="color: black">Kinder: meist Meningitis oder isoliert einseitige/beidseitige Fazialisparese</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:155.95pt;" width="208" |<span style="color: black">Doxycyclin 200 mg q24h p.o.</span><br />
<span style="color: black">für 14 d</span><br />
<br />
<span style="color: black">ODER</span><br />
<br />
<span style="color: black">Ceftriaxon</span> <span style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">2 g q24 h i.v.</span><br />
<br />
<span style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">für 14 d</span><br />
|- style="box-sizing: inherit;"<br />
| style="border-left-width:1pt;border-right-width:1pt;border-bottom-width:1pt;border-left-color:windowtext;border-right-color:windowtext;border-bottom-color:windowtext;width:85.3pt;" width="114" nowrap="" |<span style="color: black">Späte Neuroborreliose</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:77.55pt;" width="103" nowrap="" |<span style="color: black">Monate bis Jahre</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:113.35pt;" width="151" |<span style="color: black">Serologie indiziert</span><br />
<span style="color: black">im Serum/Liquor</span><br />
<br />
<span style="color: black">(Sensitivität 99-100%)</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:4cm;" width="151" |<span style="color: black">Liquorpunktion:</span><br />
<span style="color: black">typisch lymphozytäre</span><br />
<br />
<span style="color: black">Liquorpleozytose,</span><br />
<br />
<span style="color: black">Borellien-spezifischer AK-Index,</span><br />
<br />
<span style="color: black">PCR nicht indiziert</span><br />
<br />
<span style="color: black">(Sensitivität nur 10%)</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:184.25pt;" width="246" |<span style="color: black">Enzephalitis, Enzephalomyelitis,</span><br />
<span style="color: black">Meningoenzephalits,</span><br />
<br />
<span style="color: black">zerebrale Vaskultits,</span><br />
<br />
<span style="color: black">periphere Polyneuropathie</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:155.95pt;" width="208" |<span style="color: black">Ceftriaxon 2 g q24h i.v.</span><br />
<span style="color: black">für 14-21 d</span><br />
<br />
<span style="color: black">ODER</span><br />
<br />
<span style="color: black">Cefotaxim 2 g q8h i.v.</span><br />
<br />
<span style="color: black">für 14-21 d</span><br />
|- style="box-sizing: inherit;"<br />
| style="border-left-width:1pt;border-right-width:1pt;border-bottom-width:1pt;border-left-color:windowtext;border-right-color:windowtext;border-bottom-color:windowtext;width:85.3pt;" width="114" nowrap="" |<span style="color: black">Post-Lyme Syndrom</span><br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:77.55pt;" width="103" nowrap="" |<br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:113.35pt;" width="151" nowrap="" |<br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:4cm;" width="151" nowrap="" |<br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:184.25pt;" width="246" nowrap="" |<br />
| style="border-right-width:1pt;border-bottom-width:1pt;border-right-color:windowtext;border-bottom-color:windowtext;width:155.95pt;" width="208" nowrap="" |<span style="color: black">KEINE Therapie</span><br />
|}<br />
collapse;width:814pt"</div>
imported>Brinkery