Intracoronary-stent placement for coronary artery disease

Abstract

which she removed and kept. The tick was identified as Dermacentor marginatus, a species found across Europe. She was admitted to hospital on suspicion of having Lyme disease. She complained of a severe headache and on examination was found to have a necrotic eschar on the occiput surrounded by a reddish halo (figure) and four enlarged occipital lymph nodes. She received doxycycline and soon became afebrile, but she continued to complain of severe headaches, general weakness, and tiredness for 2 months. She seroconverted against R conorii and R slovaca by microimmunofluoresence but antibody levels remained low (titre 1:128). Western blot analysis showed specific antibody activity to R slovaca. No antibodies to Borrelia burgdorferi were found. R slovaca was isolated from the tick but not the blood and scalp sampled 48 h after treatment began. However, when a DNA extract prepared from the skin biopsy was incorporated into Rickettsia-specific PCR on amplification products obtained. The base sequence of this product (an RompA gene fragment) was found to be indistinguishable from that of R slovaca, strain 13-B. 3