Images in medicine
Lyme disease: An ultrastructural analysis
Enfermedad de Lyme: Un análisis ultraestructural
María G. Moreno-Treviño, David I. Orozco-Pasadas, José F. Yañez-Mijares, Ma. G. Treviño-Alanís, Gerardo Rivera-Silva
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gerardo.rivera@udem.edu
Corresponding author: Av. I. Morones Prieto # 4500 Pte, San Pedro Garza Garcia, NL 66238, Mexico.
Corresponding author: Av. I. Morones Prieto # 4500 Pte, San Pedro Garza Garcia, NL 66238, Mexico.
Academic Department, School of Medicine, University of Monterrey, Monterrey, NL, Mexico
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Las flechas señalan placa amarillenta con afectación macular del ojo izquierdo. b) Fondo de ojo tras resolución del episodio a las 4 semanas.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Mariola Michelini Sola, Magdalena Muleas Fernandez, Iñaki Cascajares Quesada" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Mariola" "apellidos" => "Michelini Sola" ] 1 => array:2 [ "nombre" => "Magdalena" "apellidos" => "Muleas Fernandez" ] 2 => array:2 [ "nombre" => "Iñaki" "apellidos" => "Cascajares Quesada" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2603924924000508?idApp=UINPBA00004N" "url" => "/26039249/0000000800000001/v5_202410180507/S2603924924000508/v5_202410180507/es/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in medicine</span>" "titulo" => "Lyme disease: An ultrastructural analysis" "tieneTextoCompleto" => true "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "María G. Moreno-Treviño, David I. Orozco-Pasadas, José F. Yañez-Mijares, Ma. G. Treviño-Alanís, Gerardo Rivera-Silva" "autores" => array:5 [ 0 => array:2 [ "nombre" => "María G." "apellidos" => "Moreno-Treviño" ] 1 => array:2 [ "nombre" => "David I." "apellidos" => "Orozco-Pasadas" ] 2 => array:2 [ "nombre" => "José F." "apellidos" => "Yañez-Mijares" ] 3 => array:2 [ "nombre" => "Ma. G." "apellidos" => "Treviño-Alanís" ] 4 => array:4 [ "nombre" => "Gerardo" "apellidos" => "Rivera-Silva" "email" => array:1 [ 0 => "gerardo.rivera@udem.edu" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cr0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Academic Department, School of Medicine, University of Monterrey, Monterrey, NL, Mexico" "identificador" => "af0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cr0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author: Av. I. Morones Prieto # 4500 Pte, San Pedro Garza Garcia, NL 66238, Mexico." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Enfermedad de Lyme: Un análisis ultraestructural" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "f0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 651 "Ancho" => 2490 "Tamanyo" => 251453 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "al0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">(A) General appearance of the lesion. (B) Transmission electron micrograph of the cytoplasm of a macrophage in the papillary dermis, where the cross section of a <span class="elsevierStyleItalic">Borrelia flagellum</span> is observed (yellow arrow, 50 000<span class="elsevierStyleHsp" style=""></span>×). (C) Transmission electron micrograph of a culture of <span class="elsevierStyleItalic">Borrelia burgdorferi</span>, where we observed the ultrastructural characteristics of the cross-section of flagella of these bacteria, including a typical microtubular arrangement surrounded by a membrane (yellow arrow) and the longitudinal sections of those flagella (green asterisks, 20 000<span class="elsevierStyleHsp" style=""></span>×). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="p0005" class="elsevierStylePara elsevierViewall">A 55-year-old female came to our clinic due to the abrupt appearance of a painful, elevated lesion on the back of the left forearm, associated with surrounding redness that was increasing progressively within 24 h. The patient had no fever or any other systemic effects. She had a history of visiting a forest 1 day ago. Physical examination showed an erythematous annular plaque measuring 7<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>6 cm in size on the back of the left forearm (<a class="elsevierStyleCrossRef" href="#f0005">Fig. 1</a>A). Induration and inflammation were present over the lesion, and local lymphadenopathy was noted. Serology for <span class="elsevierStyleItalic">Borrelia burgdorferi</span> Ospc antigen reported IgM at 6.3 U/ml (normal <<span class="elsevierStyleHsp" style=""></span>0.90), whereas IgG was normal. The histopathological study showed a moderate perivascular lymphocytic infiltrate with spongiosis. The sample taken by biopsy was also cultured and analyzed by electron microscopy, which detected the cross-section of a flagellum of the bacteria inside a macrophage in the papillary dermis (<a class="elsevierStyleCrossRef" href="#f0005">Fig. 1</a>B). A control was carried out through ultrastructural analysis in a <span class="elsevierStyleItalic">B. burgdorferi</span> culture, and the flagella of this bacterium were detected in longitudinal and transverse sections (<a class="elsevierStyleCrossRef" href="#f0005">Fig. 1</a>C). The diagnosis was Lyme disease. The patient was treated with doxycycline for 3 weeks, and the resolution of the lesion was observed.</p><elsevierMultimedia ident="f0005"></elsevierMultimedia><span id="s0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0005">Ethical consideration</span><p id="p0010" class="elsevierStylePara elsevierViewall">Patient written informed consent was obtained.</p></span><span id="s0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0010">Ethical committee</span><p id="p0015" class="elsevierStylePara elsevierViewall">Comité de Investigación de la UDEM.</p></span><span id="s1010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st1010">Registry number</span><p id="p1015" class="elsevierStylePara elsevierViewall">18092024-DER-CI.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "s0005" "titulo" => "Ethical consideration" ] 1 => array:2 [ "identificador" => "s0010" "titulo" => "Ethical committee" ] 2 => array:2 [ "identificador" => "s1010" "titulo" => "Registry number" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2024-09-18" "fechaAceptado" => "2024-09-24" "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "f0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 651 "Ancho" => 2490 "Tamanyo" => 251453 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "al0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">(A) General appearance of the lesion. (B) Transmission electron micrograph of the cytoplasm of a macrophage in the papillary dermis, where the cross section of a <span class="elsevierStyleItalic">Borrelia flagellum</span> is observed (yellow arrow, 50 000<span class="elsevierStyleHsp" style=""></span>×). (C) Transmission electron micrograph of a culture of <span class="elsevierStyleItalic">Borrelia burgdorferi</span>, where we observed the ultrastructural characteristics of the cross-section of flagella of these bacteria, including a typical microtubular arrangement surrounded by a membrane (yellow arrow) and the longitudinal sections of those flagella (green asterisks, 20 000<span class="elsevierStyleHsp" style=""></span>×). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/26039249/0000000800000001/v5_202410180507/S2603924924000557/v5_202410180507/en/main.assets" "Apartado" => array:4 [ "identificador" => "80822" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Imagen en medicina" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/26039249/0000000800000001/v5_202410180507/S2603924924000557/v5_202410180507/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2603924924000557?idApp=UINPBA00004N" ]
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