[Lyme borreliosis: census of adult patients hospitalized in Indre-et-Loire (France), from the Hospital Discharge Data (1999-2006)].

BACKGROUND

To describe the clinical forms and epidemiology of Lyme borreliosis, in French adult patients hospitalized in Indre-et-Loire (Centre region).

METHODS

Patients were recruited from standardized discharge summaries collected in the hospital database. All adult patients, hospitalized in public hospitals of the Indre-et-Loire administrative district, over a period of 8 years (1999-2006), who satisfied the European diagnostic criteria of Lyme borreliosis, were included.

RESULTS

Encoding of Lyme borreliosis had a poor positive predictive value (65%). Forty-seven adult patients presented with the 50 following clinical forms: erythema migrans (n=5), neuroborreliosis (n=32), knee single-joint arthritis (n=4), acrodermatitis chronica atrophicans (n=3), carditis (n=2), ocular borreliosis (n=2), miscellaneous (n=2). Three patients had a combination of two different clinical forms. Meningoradiculitis was the most frequent neurologic manifestation. When a cranial nerve was involved, it was constantly the facial nerve, and mainly bilaterally. Few patients in our study had erythema migrans: these patients are usually treated in a general medicine setting. Although the incidence in the Centre region was lower than in some other regions of France and Europe, the clinical spectrum of the disseminated forms was similar.

CONCLUSION

This cohort illustrates the diversity of clinical manifestations of Lyme borreliosis in hospitalized patients, particularly at disseminated and late stages as well as the complexity of its diagnosis and its epidemiological surveillance.