The Baggio–Yoshinari syndrome , formerly known as the Brazilian Lyme-like disease and Brazilian human borreliosis, is a disease transmitted by the ''
Amblyomma cajennense'' tick, but the organism that causes the infection is still unknown.
Clinical features resemble those of
Lyme disease
Lyme disease, also known as Lyme borreliosis, is a vector-borne disease caused by the ''Borrelia'' bacterium, which is spread by ticks in the genus ''Ixodes''. The most common sign of infection is an expanding red rash, known as erythema migran ...
(LD).
Presentation
A distinct feature of the syndrome is its prolonged clinical evolution, with relapsing episodes and
autoimmune dysfunction. If diagnosed in its early stages, the symptoms respond well to
antibiotics
An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and prevention o ...
. If the disease evolves to a chronic phase, it can potentially cause
oligoarthritis
Oligoarthritis (from Greek ''oligos'' - 'few') is defined as arthritis
Arthritis is a term often used to mean any disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth ...
,
cognitive impairment
Cognitive deficit is an inclusive term to describe any characteristic that acts as a barrier to the cognition process.
The term may describe
* deficits in overall intelligence (as with intellectual disabilities),
* specific and restricted defici ...
,
meningoencephalitis
Meningoencephalitis (; from ; ; and the medical suffix ''-itis'', "inflammation"), also known as herpes meningoencephalitis, is a medical condition that simultaneously resembles both meningitis, which is an infection or inflammation of the menin ...
and
erythema nodosum
Erythema nodosum (EN) is an inflammatory condition characterized by inflammation of the fat cells under the skin, resulting in tender red nodules or lumps that are usually seen on both shins. It can be caused by a variety of conditions, and typi ...
, with the patient risking to develop both articular and neurological sequelae.
[Revista Brasileira de Reumatologia, Vol.54, Issue 2, March–April 2014, Pages 148–151]
Chronic lymphomonocytic meningoencephalitis, oligoarthritis and erythema nodosum: report of Baggio-Yoshinari syndrome of long and relapsing evolution
/ref>
The neurological manifestations of BYS were first described by Yoshinari et al. including patients with peripheral neuritis, meningitis and cranial neuritis ( facial nerve palsy, diplopia
Diplopia is the simultaneous perception of two images of a single object that may be displaced horizontally or vertically in relation to each other. Also called double vision, it is a loss of visual focus under regular conditions, and is often v ...
and deafness
Deafness has varying definitions in cultural and medical contexts. In medical contexts, the meaning of deafness is hearing loss that precludes a person from understanding spoken language, an audiological condition. In this context it is written ...
).Amblyomma
''Amblyomma'' is a genus of hard ticks. Some are disease vectors, for example the Rocky Mountain spotted fever in Brazil or ehrlichiosis in the United States.
This genus is the third largest in the family Ixodidae, with its species primarily o ...
'' and ''Rhipicephalus
''Rhipicephalus'' is a genus of ticks in the family Ixodidae, the hard ticks, consisting of about 74 or 75 species. Most are native to tropical Africa.Olwoch, J. M., et al. (2007)Climate change and the genus ''Rhipicephalus'' (Acari: Ixodidae) in ...
'' genera, which could help to explain all the particularities observed in BYS versus LD.[Revista Brasileira de Reumatologia, vol.49 no.5, São Paulo, Sept./Oct. 2009]
Neurological manifestations in Baggio-Yoshinari Syndrome (Brazilian Lyme-like disease syndrome)
/ref>
Some features of BYS also resemble those found in the Southern tick-associated rash illness
Southern tick-associated rash illness (STARI) is an emerging infectious disease related to Lyme disease that occurs in southeastern and south-central United States. It is spread by tick bites and it was hypothesized that the illness was caused by ...
(STARI, also known as Masters' disease), which is found in the Southern USA.
Diagnosis
History
In 1989, Brazilian researchers Professors Domingos Baggio (an entomologist from the Biomedical Sciences Institute of the University of São Paulo
The University of São Paulo ( pt, Universidade de São Paulo, USP) is a public university in the Brazilian state of São Paulo. It is the largest Brazilian public university and the country's most prestigious educational institution, the bes ...
), Paulo Yasuda (a microbiologist from the same institute) and Natalino Hajime Yoshinari (a physician from the Rheumatology Department at University of São Paulo's Medical School[Revista Brasileira de Pesquisas Médicas e Biológicas vol.40 no.4 Ribeirão Preto Apr. 2007]
Description of Lyme disease-like syndrome in Brazil. Is it a new tick borne disease or Lyme disease variation?
/ref>
The first cases were described in Brazil
Brazil ( pt, Brasil; ), officially the Federative Republic of Brazil (Portuguese: ), is the largest country in both South America and Latin America. At and with over 217 million people, Brazil is the world's fifth-largest country by area ...
in 1992 in siblings from Cotia
Cotia is a municipality in the state of São Paulo in Brazil. It is part of the Metropolitan Region of São Paulo. The population is 253,608 (2020 est.) in an area of 323.99 km². The city is at an elevation of 853 m. Cotia is linked with t ...
, São Paulo
São Paulo (, ; Portuguese for ' Saint Paul') is the most populous city in Brazil, and is the capital of the state of São Paulo, the most populous and wealthiest Brazilian state, located in the country's Southeast Region. Listed by the Ga ...
that developed symptoms as a migrating redness, general flu-like symptoms and arthritis after being bitten by ticks. Although the symptoms were similar to those presented by patients of Lyme disease, clinical and laboratorial results were considerably different. Ticks of the ''Ixodes ricinus
''Ixodes ricinus'', the castor bean tick, is a chiefly European species of hard-bodied tick. It may reach a length of when engorged with a blood meal, and can transmit both bacterial and viral pathogens such as the causative agents of Lyme disea ...
'' complex
Complex commonly refers to:
* Complexity, the behaviour of a system whose components interact in multiple ways so possible interactions are difficult to describe
** Complex system, a system composed of many components which may interact with each ...
were not found at the risk areas; bacteria from the ''Borrelia burgdorferi
''Borrelia burgdorferi'' is a bacterial species of the spirochete class in the genus '' Borrelia'', and is one of the causative agents of Lyme disease in humans. Along with a few similar genospecies, some of which also cause Lyme disease, it mak ...
'' sensu lato complex
In biology, a species complex is a group of closely related organisms that are so similar in appearance and other features that the boundaries between them are often unclear. The taxa in the complex may be able to hybridize readily with each oth ...
—that cause Lyme disease— were not found in biological fluids and tissues of the siblings.spirochaete
A spirochaete () or spirochete is a member of the phylum Spirochaetota (), (synonym Spirochaetes) which contains distinctive diderm (double-membrane) gram-negative bacteria, most of which have long, helically coiled (corkscrew-shaped or s ...
phylum. For these reasons, the Brazilian zoonosis
A zoonosis (; plural zoonoses) or zoonotic disease is an infectious disease of humans caused by a pathogen (an infectious agent, such as a bacterium, virus, parasite or prion) that has jumped from a non-human (usually a vertebrate) to a human. ...
was considered a new disease and named Baggio–Yoshinari Syndrome (BYS), defined as: "Exotic and emerging Brazilian infectious disease, transmitted by ticks not belonging to the ''Ixodes ricinus'' complex, caused by latent spirochetes with atypical morphology, which originates LD-like symptoms, except for occurrence of relapsing episodes and auto-immune disorders".[Revista da Associação Médica Brasileira vol.56 no.3 São Paulo, 2010]
Brazilian Lyme-like disease or Baggio-Yoshinari syndrome: exotic and emerging Brazilian tick-borne zoonosis
/ref>
References
{{DEFAULTSORT:Baggio Yoshinari Syndrome
Bacterial diseases
Neurodegenerative disorders
Tick-borne diseases
Syndromes caused by microbes