ORIGINAL ARTICLE   Free access

Giornale Italiano di Dermatologia e Venereologia 2020 June;155(3):320-4

DOI: 10.23736/S0392-0488.18.05941-2

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Occurrence of Lyme disease infection in a non-endemic area in Northern Italy

Sara G. RIMOLDI ¹ ✉, Stefania MERLI ², Giovanna BESTETTI ², Vania GIACOMET ³, Giuliana CISLAGHI ⁴, Romualdo GRANDE ¹, Sergio ZANZANI ⁵, Cristina PAGANI ¹, Giusto TREVISAN ⁶, Eleonora DE FAVERI ⁵, Maria R. GISMONDO ¹, Eva RUZIĆ-SABLJIĆ ⁷ Exodes Study Group 

¹ Laboratory of Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli-Sacco, Milan, Italy; ² Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy; ³ Unit of Pediatrics, ASST Fatebenefratelli-Sacco, Milan, Italy; ⁴ Unit of Neurology, ASST Fatebenefratelli-Sacco, Milan, Italy; ⁵ Department of Veterinary Medicine, University of Milan, Milan, Italy; ⁶ Unit of Dermatology, University of Trieste, Trieste, Italy; ⁷ Laboratory for Boreliosis and Leptospirosis, University of Ljubljana, Ljubljana, Slovenia

BACKGROUND: In Italy, the incidence of human tick-borne disease has increased over the last decades. Since 2015 a multidisciplinary group has been established in Sacco Hospital for the management of the patients affected by Lyme disease (LD). A retrospective evaluation (2015-2017) was performed for LD in non-endemic areas.
METHODS: Retrospective analysis of all 1000 samples for 800 patients screened for LD antibodies at the Sacco Hospital in 3 years (2015-2017). Clinical and epidemiological data were collected and compared with the serological results.
RESULTS: Among the 800 patients screened, 134 of them were diagnosed with borreliosis during 2015 (37 cases), 2016 (31 cases) and 2017 (66 cases). Localized LD was diagnosed 100 out of 134 cases (69%): in most of them (N.=63) erythema migrans has been documented; in 37 out of 100 it was not possible to detect it. In only three cases, patients complained of different clinical symptoms such as headache, arm and facial pain respectively. 23 out of 134 cases (16%) showed a persistence of serological positivity and symptoms with osteomuscular involvement and fatigue, despite the therapy (late LD). In that same study 11 out of 134 patients (7%) received a diagnosis of neuroborreliosis.
CONCLUSIONS: Our data reported a high percentage of LD infection (19%) in a non-endemic area. The definition of a Multidisciplinary Working Group and a clinical care pathway allowed a better clinical management of LD cases treated in Sacco Hospital, Milan.

KEY WORDS: Lyme disease; Italy; Infections