{"id":563,"date":"2018-08-15T23:31:52","date_gmt":"2018-08-15T21:31:52","guid":{"rendered":"https:\/\/borelioza.sk\/o-lymskej-borelioze\/"},"modified":"2026-05-15T14:24:34","modified_gmt":"2026-05-15T12:24:34","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\" 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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\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":34,"href":"https:\/\/borelioza.sk\/en\/wp-json\/wp\/v2\/pages\/563\/revisions"}],"predecessor-version":[{"id":2231,"href":"https:\/\/borelioza.sk\/en\/wp-json\/wp\/v2\/pages\/563\/revisions\/2231"}],"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}]}}