title: Lyme disease in Poland - A serious problem?
abstract: OBJECTIVE
  We evaluated the clinical picture of patients hospitalized with Lyme disease (LD). Additionally, we analyzed the possible cause of sudden rise in LD incidence in Poland.
  
  
  METHODS
  We retrospectively analyzed medical documentation of patients admitted to the Department of Infectious Diseases and Neuroinfections, Medical University in Bialystok in 2013 with suspicion of LD. The collected data featured patients' age, gender, occupation, symptoms, clinical form of LD and final diagnosis. Additionally 38 patients with diagnosed LD and chronic joint pain, with no improvement after previous antibiotic treatment, completed the survey.
  
  
  RESULTS
  In 2013 overall 378 patients were admitted to our Department with suspicion of LD. Neuroborreliosis (NB) was confirmed in 10 out of 42 patients. Acrodermatitis chronica atrophicans (ACA) was confirmed in 5 cases. As far as patients with joint pains are concerned - in 4 cases Lyme arthritis (LA) was diagnosed, in 174 the serology and clinical symptoms indicated possibility of active infection, in 153 patients no features of active infection were found. The majority of surveyed patients had BMI over 25, they suffered from many chronic diseases, e.g. osteoarthrosis, hypertension, diabetes.
  
  
  CONCLUSIONS
  The reported incidence of LD in Poland, in our opinion, may be biased by overreporting and overdiagnosis. Nonspecific musculoskeletal and joint pain are the most frequent cause of LD suspicion and hospitalization. There is a necessity of better tests for active LD confirmation (especially in patients with musculoskeletal pain) as seroprevalence of anti Borrelia burgdorferi antibodies is high in endemic regions.
authors.affiliation: Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Czupryna
authors.affiliation: Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland. Electronic address: annamoniuszko@op.pl.
authors.forename: Anna
authors.initials: A
authors.lastname: Moniuszko-Malinowska
authors.affiliation: Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Sławomir
authors.initials: S
authors.lastname: Pancewicz
authors.affiliation: Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Garkowski
authors.affiliation: Software Department, Faculty of Computer Science, Bialystok University of Technology, Bialystok, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Gościk
authors.affiliation: Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Siemieniako
authors.affiliation: Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Zajkowska
mesh_terms: D004675:Encephalitis, Tick-Borne / Q000097:blood / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008193:Lyme Disease / Q000097:blood / Q000453:epidemiology*; D011044:Poland / Q000453:epidemiology
keywords: Epidemiology; Lyme disease; Overdiagnosis