{"id":563,"date":"2018-08-15T23:31:52","date_gmt":"2018-08-15T21:31:52","guid":{"rendered":"https:\/\/borelioza.sk\/o-lymskej-borelioze\/"},"modified":"2024-07-12T15:30:25","modified_gmt":"2024-07-12T13:30:25","slug":"o-lymskej-borelioze","status":"publish","type":"page","link":"https:\/\/borelioza.sk\/en\/o-lymskej-borelioze\/","title":{"rendered":"O LYMSKEJ BORELI\u00d3ZE"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"563\" class=\"elementor elementor-563\">\n\t\t\t\t\t\t<div class=\"elementor-inner\">\n\t\t\t\t<div class=\"elementor-section-wrap\">\n\t\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5d5b7315 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5d5b7315\" data-element_type=\"section\" id=\"preco-my\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;shape_divider_top&quot;:&quot;opacity-fan&quot;}\">\n\t\t\t\t\t<div class=\"elementor-shape elementor-shape-top\" data-negative=\"false\">\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 283.5 19.6\" preserveAspectRatio=\"none\">\n\t<path class=\"elementor-shape-fill\" style=\"opacity:0.33\" d=\"M0 0L0 18.8 141.8 4.1 283.5 18.8 283.5 0z\"\/>\n\t<path class=\"elementor-shape-fill\" style=\"opacity:0.33\" d=\"M0 0L0 12.6 141.8 4 283.5 12.6 283.5 0z\"\/>\n\t<path class=\"elementor-shape-fill\" style=\"opacity:0.33\" d=\"M0 0L0 6.4 141.8 4 283.5 6.4 283.5 0z\"\/>\n\t<path class=\"elementor-shape-fill\" d=\"M0 0L0 1.2 141.8 4 283.5 1.2 283.5 0z\"\/>\n<\/svg>\t\t<\/div>\n\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t\t\t<div class=\"elementor-row\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-5f362267\" data-id=\"5f362267\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-63ae6f0e animated-slow premium-title-icon-row premium-title-flex-start elementor-invisible elementor-widget elementor-widget-premium-addon-title\" data-id=\"63ae6f0e\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInDown&quot;}\" data-widget_type=\"premium-addon-title.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\r\n\t<div class=\"premium-title-container style3\">\r\n\t\t<h2 class=\"premium-title-header premium-title-style3\">\r\n\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"premium-title-icon premium-svg-nodraw premium-drawable-icon fas fa-bars\" aria-hidden=\"true\"><\/i>\r\n\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t<span class=\"premium-title-text\" >\r\n\t\t\t\tO LYMSKEJ BORELI\u00d3ZE\t\t\t<\/span>\r\n\t\t\t\t\r\n\t\t\t\t\t\t\t\t<\/h2>\r\n\t<\/div>\r\n\r\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-13edd3f6 animated-slow elementor-invisible elementor-widget elementor-widget-premium-divider\" data-id=\"13edd3f6\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"premium-divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\n\t\t<div class=\"premium-separator-container premium-separator-solid\" data-settings=\"solid\">\n\t\t\t<div class=\"premium-separator-wrapper\">\n\t\t\t\t<div class=\"premium-separator-wrapper-separator\">\n\t\t\t\t\t<div class=\"premium-separator-wrapper-separator-divider\">\n\t\t\t\t\t\t<div class=\"premium-separator-inner\">\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t<div class=\"premium-separator-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<div class=\"premium-separator-divider-left premium-separator-left-side\">\n\t\t\t\t\t\t\t\t\t\t<hr>\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"premium-separator-icon-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"premium-separator-icon-wrap premium-separator-img-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/borelioza.sk\/wp-content\/uploads\/elementor\/thumbs\/separator-icon-hearth-g-nuzuyibernmnov642qdcoejhv9954r3csdry3n4rgi.png\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"premium-separator-divider-right premium-separator-right-side\">\n\t\t\t\t\t\t\t\t\t\t<hr>\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t<\/div>\n\n\t\t\t\t<\/div>\n\n\t\t\t\t<div class=\"premium-clearfix\"><\/div>\n\n\t\t\t<\/div>\n\n\t\t<\/div>\n\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d5f534c elementor-widget elementor-widget-toggle\" data-id=\"d5f534c\" data-element_type=\"widget\" data-widget_type=\"toggle.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-toggle\" role=\"tablist\">\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-2241\" class=\"elementor-tab-title\" data-tab=\"1\" role=\"tab\" aria-controls=\"elementor-tab-content-2241\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"\" class=\"elementor-toggle-title\">Bor\u00e9liov\u00e1 infekcia - boreli\u00f3za (Lymsk\u00e1 choroba)<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-2241\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"1\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-2241\"><h2>V\u0161eobecn\u00e9 inform\u00e1cie o boreli\u00f3ze<\/h2><p>V letnom obdob\u00ed sa pri n\u00e1v\u0161teve pr\u00edrody \u010dasto vystavujeme mo\u017enosti infekcie bakt\u00e9riou (spiroch\u00e9tou) pren\u00e1\u0161anou klie\u0161\u0165om, s n\u00e1sledkom mo\u017en\u00e9ho infek\u010dn\u00e9ho ochorenia &#8211; boreli\u00f3zou. Premorenos\u0165 klie\u0161\u0165ov na Slovensku bor\u00e9liou je priemerne asi 10%, v niektor\u00fdch ohnisk\u00e1ch m\u00f4\u017ee by\u0165 vy\u0161\u0161ia. Predpoklad\u00e1 sa, \u017ee aby \u010dlovek mohol by\u0165 infikovan\u00fd, je potrebn\u00e1 pr\u00edtomnos\u0165 klie\u0161\u0165a na ko\u017ei viac ako 24 hod\u00edn. Preto ka\u017edodenn\u00e1 prehliadka tela i odevu na pr\u00edtomnos\u0165 klie\u0161\u0165ov m\u00f4\u017ee by\u0165 prevenciou vzniku ochorenia.<\/p><p>Boreli\u00f3za sa prejav\u00ed naj\u010dastej\u0161ie hor\u00fa\u010dkou, \u00fanavou, boles\u0165ami svalov a k\u013abov (hlavne kolien) ale predov\u0161etk\u00fdm v\u00fdraznou \u010dervenou vyr\u00e1\u017ekou, ktor\u00e1 sa postupne zv\u00e4\u010d\u0161uje na ve\u013ekos\u0165 viac ako 10 \u2013 15 cm. V tomto \u0161t\u00e1diu je najvhodnej\u0161ie vyh\u013eada\u0165 lek\u00e1ra a ochorenie d\u00f4kladne prelie\u010di\u0165 antibiotikami. U niektor\u00fdch \u013eud\u00ed sa v\u0161ak tieto ko\u017en\u00e9 prejavy neobjavia a ochorenie m\u00f4\u017ee nepoznane pokra\u010dova\u0165. \u010eal\u0161ie pr\u00edznaky skor\u00e9ho \u0161t\u00e1dia infekcie m\u00f4\u017eu by\u0165 \u00fanava, bolesti hlavy, pocit obmedzenej hybnosti \u0161ije, bolesti svalov a k\u013abov, zv\u00e4\u010d\u0161en\u00e9 lymfatick\u00e9 uzliny alebo za\u010dervenanie spojoviek. Nelie\u010den\u00e9 ochorenie m\u00f4\u017ee prejs\u0165 do chronick\u00e9ho \u0161t\u00e1dia s postihnut\u00edm srdcov\u00e9ho svalu a nervov\u00e9ho syst\u00e9mu ( z\u00e1paly mozgov\u00fdch obalov, mozgu, miechy, obrna tv\u00e1rov\u00e9ho svalstva a pod.). Vtedy je u\u017e \u010dasto potrebn\u00e9 pod\u00e1va\u0165 v nemocnici antibiotik\u00e1 do \u017eily. Diagn\u00f3zu je mo\u017en\u00e9 stanovi\u0165 vy\u0161etren\u00edm krvi \u0161peci\u00e1lnymi testami. V oblasti v\u00fdskytu klie\u0161\u0165a na ko\u017ei je obvykle mal\u00e1 ranka alebo za\u010dervenanie, ktor\u00e9 je norm\u00e1lnou reakciou na zaklie\u0161tenie.<\/p><p>Bor\u00e9liozou m\u00f4\u017ee by\u0165 po zaklie\u0161ten\u00ed nakazen\u00fd i pes, ochorenie sa prejav\u00ed hor\u00fa\u010dkou, nechutenstvom, opuchom k\u013abov, stuhnutou ch\u00f4dzou alebo kr\u00edvan\u00edm. Vtedy je potrebn\u00e9 nav\u0161t\u00edvi\u0165 veterin\u00e1ra, ktor\u00fd zah\u00e1ji antibiotick\u00fa lie\u010dbu. \u00dastup \u0165a\u017ekost\u00ed je zvy\u010dajne do 2 dn\u00ed, potrebn\u00e9 je v\u0161ak, aby pes u\u017e\u00edval antibiotik\u00e1 e\u0161te aspo\u0148 2 &#8211; 4 t\u00fd\u017edne.<\/p><h2>Prevent\u00edvne opatrenia<\/h2><p>Odpor\u00fa\u010da sa vyh\u00fdba\u0165 sa n\u00e1v\u0161tev\u00e1m oblast\u00ed, v ktor\u00fdch je vysok\u00e1 pr\u00edtomnos\u0165 klie\u0161\u0165ov \u2013 vysok\u00e1 tr\u00e1va, krovie a pod, ako i ohnisk\u00e1m s vysok\u00fdm v\u00fdskytom infikovan\u00fdch klie\u0161\u0165ov. Odpor\u00fa\u010da sa nosi\u0165 o\u0161atenie pokr\u00fdvaj\u00face \u010do najv\u00e4\u010d\u0161iu \u010das\u0165 tela, hlavne pono\u017eky, top\u00e1nky a dlh\u00e9 nohavice. Odev by mal by\u0165 svetl\u00fd, aby sa z neho dali odstr\u00e1ni\u0165 pr\u00edpadn\u00e9 neprisat\u00e9 klie\u0161te. Na nekryt\u00e9 \u010dasti tela je vhodn\u00e9 pou\u017ei\u0165 \u0161peci\u00e1lne repelenty odpudzuj\u00face klie\u0161te. Dobr\u00e9 je u\u017ei\u0165 pred prech\u00e1dzkou do pr\u00edrody i vitam\u00edny skupiny B. Ka\u017ed\u00fd de\u0148 je potrebn\u00e9 skontrolova\u0165 cel\u00e9 telo, ale i odev, vzh\u013eadom na mo\u017enos\u0165 pr\u00edtomnosti i ve\u013emi mal\u00e9ho klie\u0161\u0165a. Skontrolova\u0165 je potrebn\u00e9 i psa, ak ste ho mali so sebou. Klie\u0161\u0165a je potrebn\u00e9 odstr\u00e1ni\u0165 cel\u00e9ho, \u010do najsk\u00f4r, a najlep\u0161ie pinzetou. Pri odstra\u0148ovan\u00ed treba by\u0165 trpezliv\u00fd, telo klie\u0161\u0165a by sa nemalo rozmlia\u017edi\u0165. Odstr\u00e1nen\u00e1 mus\u00ed by\u0165 hlavne t\u00e1 \u010das\u0165 klie\u0161\u0165a, ktorou bol prisat\u00fd. V pr\u00edpade potreby, je klie\u0161\u0165a mo\u017en\u00e9 da\u0165 vy\u0161etri\u0165 na pr\u00edtomnos\u0165 bor\u00e9li\u00ed. Ak sa podar\u00ed klie\u0161\u0165a dokonale odstr\u00e1ni\u0165 do 24 hod\u00edn po zaklie\u0161ten\u00ed, pravdepodobnos\u0165 infekcie je mal\u00e1.<\/p><h2>Inform\u00e1cie pre lek\u00e1rov<\/h2><p>Lymsk\u00e1 choroba (boreli\u00f3za) je multisyst\u00e9mov\u00e9 infek\u010dn\u00e9 ochorenie postihuj\u00face naj\u010dastej\u0161ie ko\u017eu, k\u013aby, srdce a nervov\u00fd syst\u00e9m. Epidemiologick\u00fdm agensom je bakt\u00e9ria \u2013 spiroch\u00e9ta Borrelia burgdorferi, pri\u010dom v Eur\u00f3pe dominuje podtyp Borrelia afzelii vyvol\u00e1vaj\u00faca ko\u017en\u00e9 prejavy, a Borrelia garinii ktor\u00e1 sa manifestuje neurologick\u00fdmi prejavmi. Pren\u00e1\u0161a\u010dom je klie\u0161\u0165 Ixodes ricinus. Predpokladan\u00fd v\u00fdskyt na Slovensku je viac ako 1000 nov\u00fdch ochoren\u00ed ro\u010dne.<\/p><p>Prejavom skorej infekcie je erythema migrans \u2013 makulopapul\u00e1rny eryt\u00e9m ve\u013ekosti asi 15 cm, ktor\u00fd sa objav\u00ed o nieko\u013eko dn\u00ed a\u017e t\u00fd\u017ed\u0148ov po zaklie\u0161ten\u00ed. Neskor\u0161\u00edm prejavom infekcie s\u00fa artralgie a myalgie. Komplik\u00e1ciou m\u00f4\u017ee by\u0165 i myokardit\u00edda alebo perikardit\u00edda. U nelie\u010den\u00fdch pacientov sa m\u00f4\u017eu objavi\u0165 i prejavy postihnutia nervov\u00e9ho syst\u00e9mu \u2013 perif\u00e9rna l\u00e9zia VII. nervu, meningoencefalit\u00eddy a myelopolyradikuloneurit\u00eddy, op\u00edsan\u00e9 boli i neuronit\u00eddy, depresie, panick\u00e9 ataky, chronick\u00fd \u00fanavov\u00fd syndr\u00f3m a in\u00e9 prejavy. \u017diadne klinick\u00e9 manifest\u00e1cie v\u0161ak nie s\u00fa pre boreli\u00f3zu patognomick\u00e9. Diagn\u00f3za by mala by\u0165 stanoven\u00e1 na podklade epidemiologickej anamn\u00e9zy, klinick\u00e9ho obrazu a v\u00fdsledkov pomocn\u00fdch vy\u0161etren\u00ed v\u010d\u00edtane s\u00e9rologick\u00fdch.<\/p><p>V klinickej diagnostike sa \u0161tandardne vy\u0161etruj\u00fa protil\u00e1tky s antig\u00e9nom B. burgdorferi imunofluorescen\u010dnou met\u00f3dou a met\u00f3dou ELISA. IgM protil\u00e1tky s\u00fa detekovate\u013en\u00e9 3 &#8211; 6 t\u00fd\u017ed\u0148ov po infekcii, IgG protil\u00e1tky sa tvoria asi po 6 t\u00fd\u017ed\u0148och, vrcholia po \u0161iestich mesiacoch a pretrv\u00e1vaj\u00fa dlhodobo. Vzh\u013eadom na mo\u017enos\u0165 falo\u0161ne pozit\u00edvnych v\u00fdsledkov, odpor\u00fa\u010da sa v pr\u00edpade ich pozitivity n\u00e1sledn\u00e1 konfirma\u010dn\u00e1 reakcia met\u00f3dou Western Imunoblot. Na niektor\u00fdch pracovisk\u00e1ch je mo\u017en\u00e1 i detekcia tiel bor\u00e9li\u00ed prostredn\u00edctvom polymer\u00e1zovej re\u0165azovej reakcie (PCR).<\/p><p>Terapeuticky sa odpor\u00fa\u010da doxycykl\u00edn (u dospel\u00fdch), amoxycil\u00edn (aj u det\u00ed) po dobu aspo\u0148 21 dn\u00ed, v pr\u00edpade postihnutia nervov\u00e9ho syst\u00e9mu ceftriax\u00f3n alebo cefotax\u00edm intraven\u00f3zne 28 dn\u00ed.<\/p><p>O\u010dkovacie l\u00e1tky pre \u010dloveka s\u00fa v \u0161t\u00e1diu v\u00fdskumu a klinick\u00fdch \u0161t\u00fadi\u00ed, probl\u00e9mom je variabilita a neust\u00e1la zmena povrchov\u00fdch antig\u00e9nov bor\u00e9li\u00ed najm\u00e4 v Eur\u00f3pe.<\/p><p><em>Text prevzat\u00fd so s\u00fahlasom <a href=\"http:\/\/www.edusan.sk\/\">www.edusan.sk<\/a><\/em><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-2242\" class=\"elementor-tab-title\" data-tab=\"2\" role=\"tab\" aria-controls=\"elementor-tab-content-2242\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"\" class=\"elementor-toggle-title\">Prejavy infekcie - Lymsk\u00e1 boreli\u00f3za<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-2242\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"2\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-2242\"><h2>Lymsk\u00e1 boreli\u00f3za m\u00e1 skor\u00e9 a neskor\u00e9 \u0161t\u00e1dium ochorenia<\/h2><p><strong>Skor\u00e9 \u0161t\u00e1dium<\/strong><br \/>Typick\u00fdm pr\u00edznakom je pomaly \u0161\u00edriaca sa \u010derven\u00e1 \u0161kvrna, naz\u00fdvan\u00e1 erythema migrans, ktor\u00e1 sa objav\u00ed v mieste prisatia klie\u0161\u0165a. \u0160kvrna sa zv\u00e4\u010d\u0161uje a m\u00e1 ohrani\u010den\u00fd lem s bled\u0161\u00edm miestom v strede. Objavuje sa nieko\u013eko dn\u00ed po prisat\u00ed klie\u0161\u0165a, ale tie\u017e aj po nieko\u013eko t\u00fd\u017ed\u0148ov. Naj\u010dastej\u0161ia inkuba\u010dn\u00e1 doba je 7 &#8211; 14 dn\u00ed. Eryt\u00e9m sa objavuje asi u 80 % pacientov.<br \/>Skor\u00fdm pr\u00edznakom m\u00f4\u017ee by\u0165 tie\u017e hor\u00fa\u010dka, tria\u0161ka, bolesti vo svaloch, \u00fanava. Tato f\u00e1za m\u00f4\u017ee pripom\u00edna\u0165 chr\u00edpkov\u00e9 pr\u00edznaky. Preto\u017ee prisatie klie\u0161\u0165a nevedie v\u017edy ku ko\u017en\u00fdm prejavom, tieto sympt\u00f3my s\u00fa varuj\u00facimi u os\u00f4b vyskytuj\u00facich sa v pr\u00edrodnom ohnisku.<br \/>U det\u00ed, menej \u010dasto u dospel\u00fdch, sa niekedy n\u00e1jde na ko\u017ei u\u0161n\u00e9ho lal\u00f4\u010dka, nosa, na prsnej bradavke alebo na mie\u0161ku po prisat\u00ed klie\u0161\u0165a modro\u010derven\u00fd uzl\u00edk 1 &#8211; 5 cm ve\u013ek\u00fd, ktor\u00fd m\u00f4\u017ee by\u0165 sprev\u00e1dzan\u00fd zduren\u00edm pr\u00edslu\u0161n\u00fdch lymfatick\u00fdch uzl\u00edn. Niekedy sa objav\u00ed i za nieko\u013eko t\u00fd\u017ed\u0148ov a\u017e mesiacov.<br \/>Po nieko\u013ek\u00fdch t\u00fd\u017ed\u0148och, v\u00e4\u010d\u0161inou v\u0161ak nie dlh\u0161ie ne\u017e za 3 mesiace, sa m\u00f4\u017eu vyskytn\u00fa\u0165 r\u00f4zne prejavy postihnutia nervov\u00e9ho, kardiovaskul\u00e1rn\u00e9ho a k\u013ebneho syst\u00e9mu. Nervov\u00e9 pr\u00edznaky zahr\u0148uj\u00fa bolesti hlavy, ztuhnutie \u0161ije, poruchy citlivosti a hybnosti, obrny &#8211; a to hlavne tv\u00e1rov\u00e9ho nervu, bolesti v chrbte i v kon\u010datin\u00e1ch. Postihnutie k\u013ebov sa prejavuje boles\u0165ami, ktor\u00e9 maj\u00fa tendenciu sa s\u0165ahova\u0165 a trvaj\u00fa kr\u00e1tku dobu. Srdcov\u00e9 obtia\u017ee sa m\u00f4\u017eu prejavi\u0165 du\u0161nos\u0165ou a m\u00f4\u017eu pripom\u00edna\u0165 infarkt myokardu.<\/p><p><strong>Neskor\u00e9 \u0161t\u00e1dium<\/strong><br \/>Za viac ne\u017e 6 &#8211; 12 mesiacov hlavne postihnut\u00edm k\u013abov, ko\u017ee, nervov\u00e9ho syst\u00e9mu a m\u00e1 chronick\u00fd priebeh.<\/p><p><strong>Prekonan\u00edm lymskej boreli\u00f3zy nevznik\u00e1 imunita proti boreli\u00f3ze. Je mo\u017en\u00e9 sa znovu nakazi\u0165 a ochorie\u0165.<\/strong><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-2243\" class=\"elementor-tab-title\" data-tab=\"3\" role=\"tab\" aria-controls=\"elementor-tab-content-2243\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"\" class=\"elementor-toggle-title\">Nelie\u010den\u00e1 infekcia - L\u00fdmska boreli\u00f3za<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-2243\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"3\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-2243\"><p>Prejavom skorej infekcie je erythema migrans \u2013 makulopapul\u00e1rny eryt\u00e9m ve\u013ekosti asi 15 cm, ktor\u00fd sa objav\u00ed o nieko\u013eko dn\u00ed a\u017e t\u00fd\u017ed\u0148ov po zaklie\u0161ten\u00ed.<\/p><p>Neskor\u0161\u00edm prejavom infekcie s\u00fa artralgie a myalgie.<\/p><p>Komplik\u00e1ciou m\u00f4\u017ee by\u0165 i myokardit\u00edda alebo perikardit\u00edda. U nelie\u010den\u00fdch pacientov sa m\u00f4\u017eu objavi\u0165 i prejavy postihnutia nervov\u00e9ho syst\u00e9mu \u2013 perif\u00e9rna l\u00e9zia VII. nervu, meningoencefalit\u00eddy a myelopolyradikuloneurit\u00eddy, op\u00edsan\u00e9 boli i neuronit\u00eddy, depresie, panick\u00e9 ataky, chronick\u00fd \u00fanavov\u00fd syndr\u00f3m a in\u00e9 prejavy. \u017diadne klinick\u00e9 manifest\u00e1cie v\u0161ak nie s\u00fa pre boreli\u00f3zu patognomick\u00e9.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-2244\" class=\"elementor-tab-title\" data-tab=\"4\" role=\"tab\" aria-controls=\"elementor-tab-content-2244\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"\" class=\"elementor-toggle-title\">Mikrobiologick\u00e1 diagnostika L\u00fdmskej boreli\u00f3zy<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-2244\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"4\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-2244\"><h2>Priama diagnostika<\/h2><p>V postihnutom tkanive sa bor\u00e9lie nach\u00e1dzaj\u00fa v relat\u00edvne malom mno\u017estve. Mo\u017eno ich dok\u00e1za\u0165 kultiv\u00e1ciou krve, likvoru v Barbour-Stoener-Kelly \u2013ho p\u00f4de (6 t\u00fd\u017ed\u0148ov). Z\u00e1chytnos\u0165 je len asi 5%, vy\u0161\u0161ia je u exc\u00edzi\u00ed z ko\u017ee.<\/p><p>Vzh\u013eadom na n\u00edzku z\u00e1chytnos\u0165 sa nedoporu\u010duje pre be\u017en\u00fa prax. Podobne n\u00edzka z\u00e1chytnos\u0165 je pri imunoelektr\u00f3nmikroskopickom vy\u0161etren\u00ed. V praxi sa vyu\u017e\u00edva na d\u00f4kaz pr\u00edtomnosti bor\u00e9li\u00ed polymer\u00e1z\u00e1 re\u0165azov\u00e1 reakcia &#8211; PCR najm\u00e4 v likvore (12-46% z\u00e1chytnos\u0165), v synovii k\u013abu, synovi\u00e1lnej tekutine, resp. v mo\u010di.<\/p><p>Stanovenie protil\u00e1tok proti antig\u00e9nom B. burgdorferi m\u00e1 len podporn\u00fa hodnotu v diagn\u00f3ze ochorenia. Pr\u00edtomn\u00e9 protil\u00e1tky m\u00f4\u017eu by\u0165 po star\u0161\u00edch inaparentn\u00fdch infekci\u00e1ch a nemusia by\u0165 v pr\u00ed\u010dinnom vz\u0165ahu k prebiehaj\u00facemu ochoreniu. Testy na stanovenie protil\u00e1tok nie s\u00fa \u0161tandardizovan\u00e9, dostato\u010dne \u0161pecifick\u00e9 a senzit\u00edvne. Vysok\u00e1 genotypov\u00e1 a fenotypov\u00e1 heterogenita bor\u00e9li\u00ed v Eur\u00f3pe v\u00fdrazne ovplyv\u0148uje v\u00fdber vhodn\u00fdch antig\u00e9nov pre diagnostick\u00e9 testy. Protil\u00e1tky m\u00f4\u017eu by\u0165 falo\u0161ne pozit\u00edvne (syfilis, autoimunn\u00e9 ochorenia a pod). resp. falo\u0161ne negat\u00edvne (v skor\u00fdch f\u00e1zach ochorenia, pri skorej ATB terapii a pod.). Protil\u00e1tkov\u00e1 odpove\u010f u \u013eud\u00ed je zna\u010dne variabiln\u00e1, \u010do tie\u017e prispieva k probl\u00e9mom pri diagnostike tohto ochorenia.<\/p><p>1. stup\u0148ov\u00e9 testy (skr\u00edningov\u00e9)<\/p><p>ELISA s\u00fa najviac pou\u017e\u00edvan\u00e9 testy. Doporu\u010duj\u00fa sa hlavne testy s rekombinantn\u00fdmi antig\u00e9nmi. Testy od r\u00f4znych v\u00fdrobcov m\u00f4\u017eu d\u00e1va\u0165 rozdielne v\u00fdsledky.<\/p><p>Nepriama IF sa menej vyu\u017e\u00edva, je \u010dasovo n\u00e1ro\u010dn\u00e1 za\u0165a\u017een\u00e1 subjekt\u00edvnym posudzovan\u00edm ( + alebo \u2013 1 titer).<\/p><p>2. stup\u0148ov\u00fd test<\/p><p>Imunoblot umo\u017e\u0148uje stanovenie protil\u00e1tok proti jednotliv\u00fdm definovan\u00fdm antig\u00e9nom a t\u00fdm potvrdenie \u0161pecificity produkovan\u00fdch protil\u00e1tok zachyten\u00fdch skr\u00edningov\u00fdmi testami.<\/p><p>U pacientov s neuroboreli\u00f3zou je z\u00e1kladnou diagnostickou met\u00f3dou stanovenie intratek\u00e1lnej tvorby protil\u00e1tok na z\u00e1klade stanovenia hladiny imunoglobul\u00ednov v likvore a s\u00e9re.<\/p><p><em>Doc. MUDr. Sylvia Bazovsk\u00e1, PhD &#8211; katedra epidemiologie LFUK Bratislava<\/em><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-2245\" class=\"elementor-tab-title\" data-tab=\"5\" role=\"tab\" aria-controls=\"elementor-tab-content-2245\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"\" class=\"elementor-toggle-title\">Borrelia Elispot-LTT<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-2245\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"5\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-2245\"><p>Bor\u00e9liov\u00e1 infekcia neaktivuje iba humor\u00e1lnu imunitn\u00fa odpove\u010f, ale z\u00e1rove\u0148 aktivuje aj T-lymfocity. Ke\u010f Bor\u00e9lie prest\u00e1vaj\u00fa by\u0165 akt\u00edvne T-bunkov\u00e1 imunitn\u00e1 odpove\u010f nie je pr\u00edtomn\u00e1. Test ukazuje skuto\u010dn\u00fa, aktu\u00e1lnu aktivitu Borrelia burgdorferi, chronick\u00fa, alebo ak\u00fatnu L\u00fdmsku boreli\u00f3zu. Elispot-LTT je vysoko sensit\u00edvny a vie zachyti\u0165 dokonca aj jedin\u00fa Borrelia-reakt\u00edvnu Tbunku v krvi. Elispot-LTT je ve\u013emi n\u00e1pomocn\u00fd pri monitorovan\u00ed chronickej, alebo ak\u00fatnej terapie. Elispot-LTT sa za norm\u00e1lnych okolnost\u00ed stane negat\u00edvnym za 6-8 t\u00fd\u017ed\u0148ov po skon\u010den\u00ed efekt\u00edvnej terapie.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-2246\" class=\"elementor-tab-title\" data-tab=\"6\" role=\"tab\" aria-controls=\"elementor-tab-content-2246\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"\" class=\"elementor-toggle-title\">Lie\u010dba Lymskej boreli\u00f3zy<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-2246\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"6\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-2246\"><ul>\n \t<li>\n<h2>Pri zaklie\u0161ten\u00ed<\/h2>\n<div>Pri zaklie\u0161ten\u00ed a odstr\u00e1nen\u00ed klie\u0161\u0165a sa niektor\u00ed doporu\u010duj\u00fa vr\u00e1mci prevencie Doxycycline 200 mg u\u017ei\u0165 jednorazovo.<\/div>\n<div>Ak bol klie\u0161\u0165 zaklie\u0161ten\u00fd dlh\u0161ie ako 24 hod.,predt\u00fdm sa odpor\u00fa\u010dalo u\u017ei\u0165 Doxycycline 2 &times; 100 mg v trvani min. 7 dn\u00ed. Teraz sa to pova\u017euje za prekrytie prvotn\u00fdch pr\u00edznakov a nespozorovanie n\u00e1kazy.<\/div>\n<div>&nbsp;<\/div>\n<h2>Erythema migrans<\/h2>\n<table>\n<tbody>\n<tr>\n<td width=\"35%\">Doxycycline<\/td>\n<td width=\"30%\">2 &times; 200 mg p.o.<\/td>\n<td width=\"35%\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td>Penicilin V<\/td>\n<td>3 &times; 1000 mg p.o.<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Amoxicillin<\/td>\n<td>3 &times; 500 mg p.o.\u00a0alebo 2 &times; 1000 mg<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Azitromycin<\/td>\n<td>2 &times; 500 mg p.o.<\/td>\n<td><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<em>\u00a0<\/em>\n<h2>Neuro-borrelioza&nbsp;&ndash;&nbsp;ak\u00fatna<\/h2>\n<table>\n<tbody>\n<tr>\n<td width=\"35%\">Ceftriaxone<\/td>\n<td width=\"30%\">1 &times; 2000 mg i.v.<\/td>\n<td width=\"35%\">min. 28 dn\u00ed a n\u00e1sledne antibiotik\u00e1 per os<\/td>\n<\/tr>\n<tr>\n<td>Cefotaxime<\/td>\n<td>3 &times; 2000 mg i.v.<\/td>\n<td>min. 28 dn\u00ed a n\u00e1sledne antibiotik\u00e1 per os<\/td>\n<\/tr>\n<tr>\n<td>Penicillin G<\/td>\n<td>3 &times; 3000 mg i.v.<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>N\u00e1sledne peror\u00e1lne po i.v. lie\u010dbe:<\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Doxycycline<\/td>\n<td>2 &times; 200 mg p.o.<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Amoxycillin<\/td>\n<td>3 &times; 500&nbsp;&ndash;&nbsp;1000 mg p.o.<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Artritis<\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Ceftriaxone<\/td>\n<td>1 &times; 2000 mg i.v.<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Cefotaxime<\/td>\n<td>3 &times; 2000 mg i.v.<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Doxycycline<\/td>\n<td>2 &times; 200 mg p.o.<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Amoxicillin<\/td>\n<td>3 &times; 500&nbsp;&ndash;&nbsp;1000 mg p.o.<\/td>\n<td><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<em>\u00a0<\/em>\n<h2>Acrodermatitis chronica atropicans<\/h2>\n<table>\n<tbody>\n<tr>\n<td width=\"35%\">Ceftriaxone<\/td>\n<td width=\"30%\">1 &times; 2000 mg i.v.<\/td>\n<td width=\"35%\"><\/td>\n<\/tr>\n<tr>\n<td>Cefotaxime<\/td>\n<td>3 &times; 2000 mg i.v.<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Penicillin G<\/td>\n<td>3 &times; 3000 mg i.v.<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Doxycycline<\/td>\n<td>2 &times; 100 mg p.o.<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Amoxicillin<\/td>\n<td>3 &times; 500&nbsp;&ndash;&nbsp;1000 mg p.o.<\/td>\n<td><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<em>\u00a0<\/em>\n<h2>Carditis<\/h2>\n<table>\n<tbody>\n<tr>\n<td width=\"35%\">Ceftriaxone<\/td>\n<td width=\"30%\">1 &times; 2000 mg i.v.<\/td>\n<td width=\"35%\"><\/td>\n<\/tr>\n<tr>\n<td>Cefotaxime<\/td>\n<td>3 &times; 2000 mg i.v.<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Penicillin G<\/td>\n<td>3 &times; 3000 mg i.v.<\/td>\n<td><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<em>\u00a0<\/em>\n<h2>EUCALB (European Union Concerted Action on Lyme Borreliosis)<\/h2>\n<em>Neuro-borelioza chronick\u00e1<\/em>\n\n<div>Ak d\u00f4jde k relapsu symptomatologie po hore uvedenej lie\u010dbe a to celkov\u00e1 slabos\u0165, celkov\u00e1 a zv\u00fd\u0161en\u00e1 \u00fanavnos\u0165, artralgie, myalgie a pod. jedn\u00e1 sa o chronick\u00fa formu neroborreliozy.<\/div>\n<div>Lie\u010dba sa st\u00e1va komplikovanej\u0161ia, preto\u017ee sa m\u00f4\u017ee jedna\u0165 aj o koinfekciu in\u00fdch bakt\u00e9rii a protozoa ako s\u00fa Babesia, Erlichia a ine. \u010castokr\u00e1t lie\u010dba Lymskej boreliozy je \u013eah\u0161ia, ke\u010f sa koinfekcie eliminuj\u00fa.<\/div>\n<div>Jedna z naj\u010dastej\u0161\u00edch pou\u017e\u00edvan\u00fdch l\u00e1tok v po\u010diato\u010dn\u00fdch \u0161t\u00e1di\u00e1ch je Doxycycline. Je to antibiotikum tetracyklinovej rady a je ve\u013emi efekt\u00edvny v skor\u00fdch \u0161t\u00e1di\u00e1ch ak sa berie v spr\u00e1vnych d\u00e1vkach.<\/div>\n<div>Sk\u00fasenosti (americk\u00fdch) autorov v posledn\u00fdch rokoch odpor\u00fa\u010daj\u00fa bra\u0165 d\u00e1vku 400&nbsp;&ndash;&nbsp;600 mg\/de\u0148, alebo tak ve\u013ek\u00fa d\u00e1vku ktor\u00fa je pacient schopn\u00fd tolerova\u0165 (niektor\u00ed pacienti maj\u00fa na za\u010diatku lie\u010dby \u017eal\u00fado\u010dn\u00e9 probl\u00e9my, ale ich telo sa \u010dasto \u010dasom prisp\u00f4sob\u00ed a je mo\u017en\u00e9 potom d\u00e1vky zvy\u0161ova\u0165.) \u0160tandardn\u00e1 lie\u010dba doteraz bola 200 mg\/de\u0148 21 dn\u00ed, ale doteraj\u0161ie sk\u00fasenosti poukazuj\u00fa, \u017ee t\u00e1to d\u00e1vka je nedosta\u010duj\u00faca. K\u013e\u00fa\u010dom k spr\u00e1vnej terapii je teda poda\u0165 baktericidn\u00fa d\u00e1vku a tak\u00fa d\u00e1vku, ktor\u00e1 je schopn\u00e1 prejs\u0165 hematolikvorovou barierou.<\/div>\n<div>Mozog m\u00e1 tenk\u00e9 kapil\u00e1ry, ktor\u00e9 nedovolia liekom s v\u00e4\u010d\u0161ou molekulou prech\u00e1dza\u0165 a na t\u00fdchto miestach doch\u00e1dza k pre\u017e\u00edvaniu bakt\u00e9ri\u00ed. Akon\u00e1hle sa neu\u017e\u00edva dostato\u010dn\u00e1 d\u00e1vka a akon\u00e1hle sa prestane s lie\u010dbou, bakt\u00e9rie prenikn\u00fa nasp\u00e4\u0165 do tela.<\/div>\n<div>Doxycycline je schopn\u00fd prenikn\u00fa\u0165 do mozgu a d\u00e1vka 500 mg\/de\u0148 prech\u00e1dza hematolikvorovou bari\u00e9rou a pova\u017euje sa za bakteric\u00eddnu, ni\u017e\u0161ie d\u00e1vky doxycyclinu sa pova\u017euj\u00fa za bakt\u00e9riostatick\u00e9, \u010di\u017ee zastav\u00ed rast bakt\u00e9rie , ale nie je efekt\u00edvna na eradik\u00e1ciu choroby.<\/div>\n<div>Spiroch\u00e9ty B.burgdorferi ak sa dostan\u00fa do pre nich nevhodn\u00e9ho prostredia (napr. pri u\u017e\u00edvan\u00ed antibiotickej lie\u010dby) s\u00fa schopn\u00e9 vytvori\u0165 cystick\u00fa formu. Cysta nem\u00f4\u017ee by\u0165 penetrovan\u00e1 imunitn\u00fdm syst\u00e9mom a norm\u00e1lnymi antibiotikami. Tieto \u201espiace\u201c bakt\u00e9rie sa m\u00f4\u017eu aktivova\u0165 akon\u00e1hle sa prestane s lie\u010dbou.<\/div>\n<div>Te\u00f3ria, ktor\u00e1 vznikla hovor\u00ed, \u017ee spr\u00e1vna lie\u010dba pozost\u00e1va z prvotnej elimin\u00e1cie koinfekcie. Ke\u010f boli eliminovan\u00e9 koinfekcie, je potrebn\u00e9 lie\u010di\u0165 Lymsk\u00fa chorobu z troch r\u00f4znych uhlov:<\/div>\n<ul>\n \t<li>v krvnom rie\u010disku<\/li>\n \t<li>intracelul\u00e1rne<\/li>\n \t<li>a v cystickej forme<\/li>\n<\/ul>\n<div>Pri takejto lie\u010dbe bakt\u00e9ria nem\u00e1 \u0161ancu pre\u017ei\u0165.<\/div>\n<div>Antibiotik\u00e1 TTC rady, penicillinovej rady a cefalospor\u00edny s\u00fa v\u00e4\u010d\u0161inou pou\u017e\u00edvan\u00e9 v krvnom rie\u010disku.<\/div>\n<div>Makrolidy ako Rulid (Roxytromycin), Zitromax (Azytromycin) a Klacid (Klaritromycin) s\u00fa po\u017e\u00edvan\u00e9 intracelul\u00e1rne.<\/div>\n<div>Flagyl (t.j.Metronidazol), Fasigyn (Tinidazol, Fluconazol) a Plaquenil (t.j. chloroquine) s\u00fa pou\u017e\u00edvan\u00e9 na cystick\u00fa formu.<\/div>\n<div>V\u00fdhodou kombin\u00e1cie t\u00fdchto liekov je, \u017ee to zabra\u0148uje vytvoreniu bakteri\u00e1lnej rezistencie, lebo lie\u010dba prebieha na v\u0161etk\u00fdch \u00farovniach.<\/div>\n<div>\u010casto kr\u00e1t sa za\u010d\u00edna s najni\u017e\u0161\u00edmi d\u00e1vkami a d\u00e1vky s\u00fa po \u010dase zvy\u0161ovan\u00e9, v in\u00fdch pr\u00edpadoch s\u00fa tieto lieky rotovan\u00e9 a po sk\u00fasenostich efekt\u00edvnosti lie\u010dby sa vytvorili protokoly lie\u010dby.<\/div>\n<div>Prax hovor\u00ed, \u017ee pacient by mal by\u0165 100%-ne bez sympt\u00f3mov po 2 mesiace pred zastaven\u00edm antibiotickej lie\u010dby. Ak sympt\u00f3my pretrv\u00e1vaj\u00fa, pacient nie je vylie\u010den\u00fd.<\/div>\n<div>Nasleduj\u00faca tabu\u013eka je zoznam liekov, ktor\u00e9 s\u00fa be\u017ene pou\u017e\u00edvan\u00e9 pri lie\u010dbe Lymskej choroby a koinfekcie.<\/div>\n<div>T\u00e1to lie\u010dba odr\u00e1\u017ea sk\u00fasenosti americk\u00fdch autorov u pacientov s Lymskou boreliozou.<\/div>\n<table>\n<tbody>\n<tr>\n<td><em>Doryx; Minocin; Terramycin; Vibramycin, etc.<\/em><\/td>\n<td width=\"30%\"><a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/medmaster\/a682063.html\" target=\"_blank\" rel=\"noopener\">Doxycycline<\/a><br>\n<a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/uspdi\/202552.html\" target=\"_blank\" rel=\"noopener\">Tetracycline<\/a><br>\n<a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/uspdi\/202552.html\" target=\"_blank\" rel=\"noopener\">Minocycline<\/a><\/td>\n<td width=\"35%\">300&nbsp;&ndash;&nbsp;600 mg\/de\u0148<br>\n1500&nbsp;&ndash;&nbsp;2000 mg\/de\u0148<br>\n200&nbsp;&ndash;&nbsp;400 mg\/de\u0148<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<div>Antibiotik\u00e1 tetracyklinovej rady s\u00fa pou\u017e\u00edvan\u00e9 na lie\u010denie mnoh\u00fdch r\u00f4znych bakteri\u00e1lnych infekci\u00ed, s\u00fa to bakteriostatik\u00e1 v n\u00edzkych d\u00e1vkach. Pre mnoho bakt\u00e9ri\u00ed, ktor\u00e9 maj\u00fa \u017eivotn\u00fd cyklus kr\u00e1tky a reprodukuj\u00fa sa s r\u00e1dovo min\u00fatovo, n\u00edzke d\u00e1vky s\u00fa terapeuticky \u00fa\u010dinn\u00e9, nako\u013eko bakt\u00e9rie zomr\u00fa sk\u00f4r ako dostan\u00fa \u0161ancu sa reprodukova\u0165. Ale pri Lymskej borelioze sa spiroch\u00e9ta reprodukuje v omnoho dlh\u0161om \u010dasovom horizonte a tak spiroch\u00e9ty nebud\u00fa eliminovan\u00e9 s bakteriostatick\u00fdmi d\u00e1vkami. Vy\u0161\u0161ie d\u00e1vky s\u00fa potrebn\u00e9, aby sa dosiahla bakteric\u00eddnos\u0165 a aby bol zabezpe\u010den\u00fd prestup hematolikvorovou barierou. Doxycycline je \u010dasto prv\u00e1 vo\u013eba v lie\u010dbe, nako\u013eko eliminuje Erlichiozov\u00fa koinfekciu.<\/div>\n<div>Ve\u013emi d\u00f4le\u017eit\u00e1 pozn\u00e1mka, podporn\u00e1 lie\u010dba miner\u00e1lov ako s\u00fa Ca,Fe,Ca by nemali by\u0165 u\u017e\u00edvan\u00e9 po\u010das 2 hod\u00edn po u\u017eit\u00ed doxycyklinu, nako\u013eko sa m\u00f4\u017ee zn\u00ed\u017ei\u0165 a\u017e zastavi\u0165 absorbcia antibiotika.<\/div>\n<table>\n<tbody>\n<tr>\n<td width=\"35%\">Amoxil; Biomox; Polymox; Trimox; Wymox, etc.<\/td>\n<td width=\"30%\"><a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/medmaster\/a685001.html\" target=\"_blank\" rel=\"noopener\">Amoxicillin<\/a><br>\n<a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/uspdi\/202446.html\" target=\"_blank\" rel=\"noopener\">Ampicillin<\/a><\/td>\n<td width=\"35%\">1500&nbsp;&ndash;&nbsp;4000 mg\/de\u0148<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<strong>Tieto antibiotik\u00e1 s\u00fa penicillinovej rady a s\u00fa bakteric\u00eddne.<\/strong>\n<table>\n<tbody>\n<tr>\n<td width=\"35%\">Ceftin, Ceclor<br>\nBiocef; Keflex<br>\nRocephin<br>\nLendacin<\/td>\n<td width=\"30%\"><a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/uspdi\/202119.html\">Cephalosporin<\/a><br>\n<a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/medmaster\/a682733.html\">Cephalexin<\/a><br>\n<a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/medmaster\/a685032.html\">Ceftriaxone Sodium<\/a><br>\nCeftriaxone<\/td>\n<td width=\"35%\">3 &times; 1000 mg\/de\u0148<br>\n1 &times; 2000 mg\/de\u0148<br>\n1 &times; 2000 mg\/de\u0148<br>\n&nbsp;<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<strong>Cefalosporiny sa pod\u00e1vaj\u00fa intraven\u00f3zne v trvan\u00ed vid sch\u00e9ma vy\u0161\u0161ie.<\/strong>\n<table>\n<tbody>\n<tr>\n<td width=\"35%\">Mepron<br>\nMalarone<\/td>\n<td width=\"30%\"><a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/medmaster\/a693003.html\">Atovaquone<\/a><br>\n<a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/uspdi\/500229.html\">Atovaquone + Proguanil<\/a><\/td>\n<td width=\"35%\">2 &times; 750 mg\/de\u0148<br>\nDostupn\u00e9 250 mg a 100 mg tabl<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<em><strong>Tieto l\u00e1tky v kombin\u00e1cii s Zitromax (Aziytromycin) a Trimethoprim-sulfamethoxazolom sa u\u017e\u00edvaj\u00fa ako prevencia vo\u010di Babesii.<\/strong><\/em>\n<table>\n<tbody>\n<tr>\n<td width=\"35%\">Bactrim, Septra<\/td>\n<td width=\"30%\"><a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/uspdi\/202781.html\">Trimethoprim-sulfamethoxazole<\/a><\/td>\n<td width=\"35%\">2 &times; 80 mg&nbsp;&ndash;&nbsp;400 mg\/de\u0148<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<div>U\u017e\u00edva sa s Mepronom a Azitromycinom alebo Cleocinom a Quininom.<\/div>\n<div>Pol\u010das rozpadu je 12 hod\u00edn, tak\u017ee sa u\u017e\u00edvaj\u00fa 2 &times; denne. Mus\u00ed sa pi\u0165 ve\u013ea tekut\u00edn ako prevencia tvorby mo\u010dov\u00fdch kame\u0148ov.<\/div>\n<div>Zistilo sa (v \u0161t\u00fadi\u00e1ch) \u017ee 89 % t\u00fdch ktor\u00ed u\u017e\u00edvali Trimethoprim s jednou s hore uveden\u00fdch kombin\u00e1ci\u00ed boli vylie\u010den\u00ed z Babesie a u mnoh\u00fdch t\u00fdch, ktor\u00ed neu\u017e\u00edvali t\u00fato kombin\u00e1ciu do\u0161lo k relepsu.<\/div>\n<table>\n<tbody>\n<tr>\n<td width=\"35%\">Proloprim, Trimpex<\/td>\n<td width=\"30%\"><a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/medmaster\/a684025.html\">Trimethoprim<\/a><\/td>\n<td width=\"35%\">200 mg\/de\u0148<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nNiektor\u00ed pacienti s\u00fa alergick\u00fd na sulfamethoxazol, preto je tu samotn\u00fd trimethoprim.\n<table>\n<tbody>\n<tr>\n<td width=\"35%\">Rulid, Rothricin<\/td>\n<td width=\"30%\">Roxithromycin<\/td>\n<td width=\"35%\">2 &times; 300 mg\/de\u0148<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<div>Patr\u00ed medzi makrolidy, prech\u00e1dza hematolikvorovou barierou.<\/div>\n<div>Makrolidy sa kombinuj\u00fa s Trimethoprim-sulfamethaxozolom a ak lie\u010dime naviac Babesiu je taktie\u017e do kombin\u00e1cie pridan\u00fd Mepron. Zitromax a Klacid s\u00fa \u010fa\u013e\u0161ie makrolidy. Makrolidy p\u00f4sobia na intracellul\u00e1rnej \u00farovni.<\/div>\n<table>\n<tbody>\n<tr>\n<td width=\"35%\">Zithromax<br>\nKlacid<\/td>\n<td width=\"30%\"><a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/uspdi\/202642.html\" target=\"_blank\" rel=\"noopener\">Azithromycin<\/a><br>\n<a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/uspdi\/202667.html\" target=\"_blank\" rel=\"noopener\">Clarithromycin<\/a><\/td>\n<td width=\"35%\">250 mg&nbsp;&ndash;&nbsp;600 mg\/de\u0148<br>\n1500 mg\/de\u0148<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nU\u017e\u00edvaj\u00fa sa na pr\u00e1zdny \u017eal\u00fadok na lep\u0161ie vstreb\u00e1vanie. Hladina Zithromaxu zost\u00e1va v tele 68 hod\u00edn, preto sa u\u017e\u00edva ka\u017ed\u00fd druh\u00fd de\u0148. U niektor\u00fdch pacientov viedla k \u00faspe\u0161nosti lie\u010dba e\u0161te v kombin\u00e1cii s Plaquenilom aw Amoxicillinom.\n<table>\n<tbody>\n<tr>\n<td width=\"35%\">Cleocin\/Dalacin<\/td>\n<td width=\"30%\"><a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/uspdi\/202145.html\" target=\"_blank\" rel=\"noopener\">Clindamycin<\/a><\/td>\n<td width=\"35%\">3 &times; 600 mg\/de\u0148<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nU\u017e\u00edva sa v kombin\u00e1cii s Quininom a Trimetho-sulfamethaxolom. T\u00e1to kombin\u00e1cia sa ve\u013emi neosved\u010dila, pacienti ju \u0165a\u017eko tolerovali, u niktor\u00fdch do\u0161lo k hor\u00fa\u010dkam, bolestiam hlavy a k strate sluchu.\n<table>\n<tbody>\n<tr>\n<td width=\"35%\">Quinamm<\/td>\n<td width=\"30%\"><a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/medmaster\/a682322.html\" target=\"_blank\" rel=\"noopener\">Quinine<\/a><\/td>\n<td width=\"35%\">3 &times; 650 mg\/de\u0148<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nBerie sa v kombin\u00e1cii s Cleocinom. Tonic Water obsahuje 50&nbsp;&ndash;&nbsp;70 mg chininu\/liter.\n<table>\n<tbody>\n<tr>\n<td width=\"35%\">Plaquenil<\/td>\n<td width=\"30%\">Chloroquine\n<a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/medmaster\/a601240.html\" target=\"_blank\" rel=\"noopener\">Hydroxychloroquine<\/a><\/td>\n<td width=\"35%\">200 mg&nbsp;&ndash;&nbsp;400 mg\/de\u0148<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nPatri medzi antimalarik\u00e1, na lie\u010dbu Babeziozy sa u\u017e\u00edva v kombin\u00e1cii s Quininom. Plaquenil v kombin\u00e1cii s Doxycyklinom sa pou\u017e\u00edva na lie\u010dbu cystickej formy Lymskej choroby. Tak isto sa pou\u017e\u00edva v kombin\u00e1cii s Clarithromycinom na cystick\u00fa formu. V zriedkav\u00fdch pr\u00edpadoch u niektor\u00fdch pacientov sa vyskytli poruchy zraku, je potrebn\u00e9 u pacientov o\u010dn\u00e9 kontroly.\n<table>\n<tbody>\n<tr>\n<td width=\"35%\">Flagyl<br>\nFasigyn<\/td>\n<td width=\"30%\"><a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/uspdi\/202365.html\">Metronidazole<\/a><br>\nTinidazole<\/td>\n<td width=\"35%\">2 &times; 750 mg\/de\u0148<br>\n1500 mg&nbsp;&ndash;&nbsp;3000 mg\/de\u0148<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nT\u00e1to l\u00e1tka je po\u017e\u00edvan\u00e1 na cystick\u00fa formu Lymskej choroby, nemal by sa u\u017e\u00edva\u0165 s tetracyklinom. Pou\u017e\u00edva sa rad\u0161ej v kombin\u00e1cii s cefalospor\u00ednmi. Nesmie sa po\u010das lie\u010dby u\u017e\u00edva\u0165 alkohol preto\u017ee vyvol\u00e1va prudk\u00e9 reakcie. Niektor\u00ed \u013eudia zle tolerovali vy\u0161\u0161ie d\u00e1vky, preto je lep\u0161ie za\u010da\u0165 lie\u010dbu na ni\u017e\u0161\u00edch d\u00e1vkach a postupne zvy\u0161ova\u0165 po hranicu tolerancie. Treba pravidelne kontrolova\u0165 hepat. markery a m\u00f4\u017ee sp\u00f4sobova\u0165 polyneuropathie.\n<table>\n<tbody>\n<tr>\n<td width=\"35%\">Rifadin, Rimactane<\/td>\n<td width=\"30%\">Rifampicin<\/td>\n<td width=\"35%\">1200 mg\/de\u0148<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nU\u017e\u00edva sa v kombin\u00e1cii s Doxycyklinom ako lie\u010dba Bartonelli a Ehrlichie.\n<table>\n<tbody>\n<tr>\n<td width=\"35%\">Tobradex<br>\nGentamycin<\/td>\n<td width=\"30%\"><a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/uspdi\/203776.html\" target=\"_blank\" rel=\"noopener\">Tobramycin\/Dexamethasone<\/a><br>\n<a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/uspdi\/202604.html\" target=\"_blank\" rel=\"noopener\">Gentamycin<\/a><\/td>\n<td width=\"35%\">.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nObe patria medzi aminoglycozidy a pou\u017e\u00edvaj\u00fa sa v lie\u010dbe Bartonelli. Maj\u00fa v\u0161ak ne\u017eiad\u00face \u00fa\u010dinky, m\u00f4\u017eu sp\u00f4sobi\u0165 po\u0161kodenie vestibul. apar\u00e1tu (sluch\/ekvilibrium)\n<table>\n<tbody>\n<tr>\n<td width=\"35%\">Hep-Lock; Heparin Flush; Heparin Lock<\/td>\n<td width=\"30%\"><a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/medmaster\/a601145.html\" target=\"_blank\" rel=\"noopener\">Heparin<\/a><\/td>\n<td width=\"35%\">Injekcie, ktor\u00e9 si aplikuj\u00fa pacienti doma<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nUd\u00e1va sa, \u017ee tie l\u00e1tky, ktor\u00e9 riedia krv zlep\u0161uj\u00fa cirkul\u00e1ciu a zvy\u0161uj\u00fa efektivitu antibiotickej lie\u010dby. U ve\u013ea pacientov sa zistil hyperkoagula\u010dn\u00fd stav.\n<table>\n<tbody>\n<tr>\n<td width=\"35%\">Questran<\/td>\n<td width=\"30%\"><a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/medmaster\/a682672.html\" target=\"_blank\" rel=\"noopener\">cholestyramine<\/a> (CSM)<\/td>\n<td width=\"35%\">Zvy\u010dajne 1 odmerka 4 &times; denne<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nT\u00e1to l\u00e1tka via\u017ee \u017el\u010dov\u00e9 kyseliny a tak pom\u00e1ha ich odstr\u00e1ni\u0165 z tela a zlep\u0161uje t\u00fdm pe\u010de\u0148ov\u00e9 funkcie, ktor\u00e9 aj tak dost\u00e1vaj\u00fa n\u00e1por pri u\u017e\u00edvan\u00ed antibiot\u00edk, naviec viacer\u00e9 pr\u00e1ce poukazovali na toxin, ktor\u00e9 vylu\u010dovali spiroch\u00e9ty B. burgdorferi, ktor\u00e9 boli neuro a hepatotoxick\u00e9.\n<table>\n<tbody>\n<tr>\n<td width=\"35%\">Mycostatin; Mycostatin Pastilles; Nilstat; Nystex<br>\nDiflucan<\/td>\n<td width=\"30%\"><a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/medmaster\/a682758.html\" target=\"_blank\" rel=\"noopener\">Nystatin<\/a><br>\n<a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/medmaster\/a690002.html\" target=\"_blank\" rel=\"noopener\">Fluconazole<\/a><\/td>\n<td width=\"35%\">&nbsp;<br>\n200 mg\/de\u0148<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nTieto l\u00e1tky sa pou\u017e\u00edvaj\u00fa na kvasinkov\u00e9 infekcie pri dlhodobom u\u017e\u00edvan\u00ed antibiotickej lie\u010dby, naviac nemeck\u00ed autori publikovali u\u017e\u00edvanie 200 mg Flukonazolu denne v trvan\u00ed 28 dn\u00ed ako \u00fa\u010dinn\u00fa lie\u010dbu na cystick\u00fa formu Lymskej choroby.\n<p>&nbsp;<\/p>\n<h2>Alternat\u00edvna lie\u010dba<\/h2>\n<table>\n<tbody>\n<tr>\n<td width=\"35%\">Hyperbaric Oxygen Treatment (HBOT)<br>\nHyperbar. kyslikov\u00e1 lie\u010dba<\/td>\n<td width=\"65%\">Je to lie\u010dba, ktor\u00e1 sa deje vo vysokotlakovej kysl\u00edkovej komore. Ve\u013ea pacientov ud\u00e1valo zlep\u0161enie klin. Stavu, ale pova\u017euje sa len ako podporn\u00e1 lie\u010dba. U det\u00ed sa zistila lep\u0161ia odpove\u010f na lie\u010dbu. Odpor\u00fa\u010da sa 40 a viac 60&nbsp;&ndash;&nbsp;90 min\u00fatov\u00fdch seden\u00ed. Jedno sedenie stoj\u00ed 150&nbsp;&ndash;&nbsp;200 USD.<\/td>\n<\/tr>\n<tr>\n<td width=\"35%\"><a href=\"http:\/\/home.pon.net\/caat\/lyme\/treatment1.htm#icht\">ICHT<\/a> (internal heat by use of Dinitrophenol, Usnic acid)<br>\nIntracellul\u00e1rna hypertermick\u00e1 lie\u010dba pri pou\u017eit\u00ed Dinitrophenolu alebo kys. Ur\u00f3novej (vznik\u00e1 enzymat. oxid\u00e1ciou gluk\u00f3zy)<\/td>\n<td width=\"65%\">Je to experiment\u00e1lny lie\u010debn\u00fd postup pre Lym. chorobu, kde sa zvy\u0161uje intracellur\u00e1lna teplota na hladiny dosta\u010duj\u00face yabitie spiroch\u00e9t. V\u00fdsledky poukazuj\u00fa na efektivitu elimin\u00e1cie sympt\u00f3mov, ale nie je zn\u00e1me \u010di sa jedn\u00e1 o dlhodob\u00fa lie\u010dbu. Lie\u010dba si vy\u017eaduje 5&nbsp;&ndash;&nbsp;10 d\u0148ov\u00fa hospitaliz\u00e1ciu. Stoj\u00ed to 20 000 USD, ale pri pozitivite Westernblotu menej ako 45 dn\u00ed, lie\u010dba je za 10 000 USD.<\/td>\n<\/tr>\n<tr>\n<td width=\"35%\">Rife Machine<\/td>\n<td width=\"65%\">Je to terapia, ktor\u00e1 zahr\u0148uje vyslanie slab\u00e9ho elektrick\u00e9ho pr\u00fadu cez telo pacienta pri r\u00f4znych frekvenci\u00e1ch. Predpoklad\u00e1 sa, \u017ee ka\u017ed\u00e1 bakt\u00e9ria alebo mikr\u00f3b je citliv\u00e1 na ur\u010dit\u00fa frekvenciu, ktor\u00e1 ju zabije alebo zabrzd\u00ed rast.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n<\/ul>\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-2247\" class=\"elementor-tab-title\" data-tab=\"7\" role=\"tab\" aria-controls=\"elementor-tab-content-2247\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"\" class=\"elementor-toggle-title\">Vy\u0161etrenie infek\u010dnosti prisat\u00e9ho klie\u0161\u0165a<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-2247\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"7\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-2247\"><div><p>Vy\u0161etrenie infek\u010dnosti prisat\u00e9ho klie\u0161\u0165a na pr\u00edtomnos\u0165 bor\u00e9li\u00ed v\u00a0tmavom poli, mikroskopickou met\u00f3dou.<\/p><p>Klie\u0161\u0165a m\u00f4\u017eete prinies\u0165 osobne do na\u0161ej ambulancie po\u010das ordina\u010dn\u00fdch hod\u00edn.<br \/>Predt\u00fdm je potrebn\u00e9 sa telefonicky informova\u0165 na \u010d\u00edsle\u00a0 +421 2 206 206 88 ( PO-PIA 9.00- 15.00 )<\/p><p>Klie\u0161\u0165a je mo\u017en\u00e9 taktie\u017e zasla\u0165 po\u0161tou na na\u0161u adresu:<\/p><p>MUDr. \u010eurovsk\u00e1 Judita<br \/>BCB Clinic<br \/>Radiova 41<br \/>821 02 Bratislava<\/p><p>Po odstr\u00e1nen\u00ed klie\u0161\u0165a z\u00a0ko\u017ee je potrebn\u00e9 zabr\u00e1ni\u0165 vyschnutiu klie\u0161\u0165a. Vlo\u017ete klie\u0161\u0165a do igelitov\u00e9ho s\u00e1\u010dku zabalen\u00e9ho do vlhkej vaty, pr\u00edpadne, pokia\u013e je klie\u0161\u0165 \u017eiv\u00fd priba\u013ete steblo tr\u00e1vy. Obal nepriedu\u0161ne uzavrite, vlo\u017ete do po\u0161tovej ob\u00e1lky spolu s\u00a0objedn\u00e1vkou a\u00a0za\u0161lite na na\u0161u hore uveden\u00fa adresu. Nezabudnite uvies\u0165:<\/p><ul><li>spiato\u010dn\u00fa po\u0161tov\u00fa adresu<\/li><li>telef\u00f3nne \u010d\u00edslo alebo e-mail<\/li><li>lokalitu, kde ste klie\u0161\u0165a pravdepodobne chytili (\u00fazemie Slovenska)<\/li><\/ul><p><a href=\"https:\/\/borelioza.sk\/wp-content\/uploads\/2024\/07\/objednavka-vysetrenie-kliesta-2024.docx\"><strong>Objedn\u00e1vka <\/strong><\/a> anal\u00fdzy klie\u0161\u0165a na pr\u00edtomnos\u0165 patog\u00e9nov\u00a0(MS word dokument)<\/p><p>Okrem klie\u0161\u0165a nevy\u0161etrujeme \u017eiadny in\u00fd materi\u00e1l.<\/p><\/div><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-438b2ddb elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"438b2ddb\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t\t\t<div class=\"elementor-row\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-inner-column elementor-element elementor-element-6bb1d447\" data-id=\"6bb1d447\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap\">\n\t\t\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-inner-column elementor-element elementor-element-1664c903\" data-id=\"1664c903\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7375a111 elementor-widget elementor-widget-premium-addon-button\" data-id=\"7375a111\" data-element_type=\"widget\" data-widget_type=\"premium-addon-button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\r\n\r\n\t\t<a class=\"premium-button premium-button-style4 premium-btn-lg premium-button-style4-bottom\" href=\"http:\/\/borelioza.sk\/#sluzby\">\r\n\t\t\t<div class=\"premium-button-text-icon-wrapper\">\r\n\t\t\t\t\t\t\t\t<span >\r\n\t\t\t\t\tSP\u00c4\u0164\t\t\t\t<\/span>\r\n\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t<div class=\"premium-button-style4-icon-wrapper bottom\">\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"fa fa-arrow-left\" aria-hidden=\"true\"><\/i>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t<\/a>\r\n\r\n\r\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-inner-column elementor-element elementor-element-18fbfa11\" data-id=\"18fbfa11\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap\">\n\t\t\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>O LYMSKEJ BORELI\u00d3ZE Bor\u00e9liov\u00e1 infekcia &#8211; boreli\u00f3za (Lymsk\u00e1 choroba) V\u0161eobecn\u00e9 inform\u00e1cie o boreli\u00f3ze V letnom obdob\u00ed sa pri n\u00e1v\u0161teve pr\u00edrody \u010dasto vystavujeme mo\u017enosti infekcie bakt\u00e9riou (spiroch\u00e9tou) pren\u00e1\u0161anou klie\u0161\u0165om, s n\u00e1sledkom mo\u017en\u00e9ho infek\u010dn\u00e9ho ochorenia &#8211; boreli\u00f3zou. Premorenos\u0165 klie\u0161\u0165ov na Slovensku bor\u00e9liou je priemerne asi 10%, v niektor\u00fdch ohnisk\u00e1ch m\u00f4\u017ee by\u0165 vy\u0161\u0161ia. Predpoklad\u00e1 sa, \u017ee aby \u010dlovek [&hellip;]<\/p>\n","protected":false},"author":9,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"class_list":["post-563","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/borelioza.sk\/en\/wp-json\/wp\/v2\/pages\/563","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/borelioza.sk\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/borelioza.sk\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/borelioza.sk\/en\/wp-json\/wp\/v2\/users\/9"}],"replies":[{"embeddable":true,"href":"https:\/\/borelioza.sk\/en\/wp-json\/wp\/v2\/comments?post=563"}],"version-history":[{"count":31,"href":"https:\/\/borelioza.sk\/en\/wp-json\/wp\/v2\/pages\/563\/revisions"}],"predecessor-version":[{"id":2061,"href":"https:\/\/borelioza.sk\/en\/wp-json\/wp\/v2\/pages\/563\/revisions\/2061"}],"wp:attachment":[{"href":"https:\/\/borelioza.sk\/en\/wp-json\/wp\/v2\/media?parent=563"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}