Lyme borreliosis in Brazil: a critical review on the Baggio-Yoshinari syndrome (Brazilian Lyme-like disease).

IF 19 1区 医学 Q1 MICROBIOLOGY Clinical Microbiology Reviews Pub Date : 2024-11-04 DOI:10.1128/cmr.00097-24
Marcelo B Labruna, Álvaro A Faccini-Martínez, Sebastián Muñoz-Leal, Matias P J Szabó, Rodrigo N Angerami
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Abstract

SUMMARYLyme borreliosis or Lyme disease is the most frequently reported tick-borne disease in the Northern Hemisphere. In countries of the Southern Hemisphere, such as Brazil, since the early 1990s, some researchers have argued for the existence of an autochthonous Lyme-like borreliosis, known locally as the Baggio-Yoshinari syndrome (BYS), an alleged "Brazilian borreliosis" supposedly caused by a different strain of Borrelia burgdorferi and transmitted by hard ticks. Currently, the existence of BYS in Brazil is still accepted by a large part of the human health care workers, scientists, medical societies, and patients. In fact, this alleged "Brazilian borreliosis" has been the tick-borne zoonotic disease with the greatest number of reported cases and published studies in Brazil during this century, second only to Brazilian spotted fever. In this manuscript, we reviewed all manuscripts directly related to BYS that have been published in Brazil during the last 35 years. This analysis included 199 individual human cases that have been reported in Brazil since 1989, plus multiple studies on ticks, domestic, and wild animals. Our revision aimed to provide a critical opinion on whether the current published works allow healthcare workers, public health agencies, and patients to accept the existence of Lyme disease, BYS, or other Lyme borreliosis-related disease in Brazil. For this purpose, we evaluated the strengths and weaknesses of each published study, considering the diagnostic methods used, such as serological, microbiological, and molecular analyses. Based on these evaluations, we conclude that there is not enough evidence to support the occurrence of Lyme borreliosis in Brazil or that BYS (Brazilian Lyme-like disease) is caused by a bacterium of the genus Borrelia. This assumption is based on the inaccuracy, unreliability, and misinterpretation of the different diagnostic methods that have been used in Brazil. Recognizing the lack of technical evidence for the occurrence of Lyme borreliosis in Brazil has highly relevant implications. For example, it becomes imperative to raise awareness among the country's medical profession, as they have adopted unnecessary and extreme therapies recommended for patients with a supposed borrelial infection, including BYS, in Brazil. Finally, the technical analyses carried out in this study could be applied to other countries in the Southern Hemisphere (e.g., Argentina, South Africa, Australia), where cases classified and alleged as Lyme disease have been reported.

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巴西的莱姆包虫病:巴吉奥-约希纳里综合征(巴西莱姆样病)点评。
摘要莱姆包虫病或莱姆病是北半球报告最频繁的蜱媒疾病。在南半球国家,如巴西,自 20 世纪 90 年代初以来,一些研究人员一直在争论是否存在一种类似莱姆病的本地包虫病,当地人称之为 Baggio-Yoshinari 综合征(BYS),一种所谓的 "巴西包虫病",据说是由不同的包柔氏菌株引起的,由硬蜱传播。目前,大部分人类卫生保健工作者、科学家、医学会和病人仍然认可巴西存在巴氏综合征。事实上,这种所谓的 "巴西包虫病 "是本世纪巴西报告病例和发表研究最多的蜱媒人畜共患病,仅次于巴西斑疹热。在本手稿中,我们回顾了过去 35 年中在巴西发表的所有与巴西包虫病直接相关的手稿。该分析包括自 1989 年以来在巴西报告的 199 例人类病例,以及关于蜱、家畜和野生动物的多项研究。我们的修订旨在就目前发表的作品是否允许医疗工作者、公共卫生机构和患者接受莱姆病、BYS 或其他莱姆包虫病相关疾病在巴西的存在提出批评意见。为此,我们考虑到所使用的诊断方法,如血清学、微生物学和分子分析,评估了每项已发表研究的优缺点。根据这些评估,我们得出结论:没有足够的证据证明巴西存在莱姆-博雷利病,也没有足够的证据证明 BYS(巴西莱姆样病)是由博雷利属细菌引起的。这一假设的依据是巴西使用的不同诊断方法的不准确性、不可靠性和误读。认识到缺乏技术证据证明巴西存在莱姆-博雷利病,具有非常重要的意义。例如,当务之急是提高巴西医学界的认识,因为他们对巴西的假定包虫病感染者(包括 BYS)采用了不必要的极端疗法。最后,本研究中进行的技术分析可应用于南半球的其他国家(如阿根廷、南非、澳大利亚),这些国家也有被归类为莱姆病的病例报告。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Clinical Microbiology Reviews
Clinical Microbiology Reviews 医学-微生物学
CiteScore
54.20
自引率
0.50%
发文量
38
期刊介绍: Clinical Microbiology Reviews (CMR) is a journal that primarily focuses on clinical microbiology and immunology.It aims to provide readers with up-to-date information on the latest developments in these fields.CMR also presents the current state of knowledge in clinical microbiology and immunology.Additionally, the journal offers balanced and thought-provoking perspectives on controversial issues in these areas.
期刊最新文献
American Society for Microbiology evidence-based laboratory medicine practice guidelines to reduce blood culture contamination rates: a systematic review and meta-analysis. Lyme borreliosis in Brazil: a critical review on the Baggio-Yoshinari syndrome (Brazilian Lyme-like disease). Comprehensive analysis of the global impact and distribution of tick paralysis, a deadly neurological yet fully reversible condition. Molecular diagnostics in cerebrospinal fluid for the diagnosis of central nervous system infections. Harnessing the host response for precision infectious disease diagnosis.
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