<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0465-546X</journal-id>
<journal-title><![CDATA[Medicina y Seguridad del Trabajo]]></journal-title>
<abbrev-journal-title><![CDATA[Med. segur. trab.]]></abbrev-journal-title>
<issn>0465-546X</issn>
<publisher>
<publisher-name><![CDATA[Escuela Nacional de Medicina del Trabajo. Instituto de Salud Carlos III]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0465-546X2019000400285</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Enfermedad de Lyme crónica vs. Síndrome Post-tratamiento Lyme &#8212; a propósito de un caso en el ámbito laboral de Navarra]]></article-title>
<article-title xml:lang="en"><![CDATA[Chronic Lyme Disease vs. Lyme Post-treatment Syndrome &#8212; about a case in the Navarra workplace]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Osinaga]]></surname>
<given-names><![CDATA[Ignacio Pascual]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mollov]]></surname>
<given-names><![CDATA[Asan Iknurov]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Función Pública, Interior y Justicia Departamento de Presidencia Servicio de Prevención de Riesgos Laborales]]></institution>
<addr-line><![CDATA[Pamplona Navarra]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Unidad Docente de Medicina Del Trabajo de Navarra  ]]></institution>
<addr-line><![CDATA[Pamplona ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2019</year>
</pub-date>
<volume>65</volume>
<numero>257</numero>
<fpage>285</fpage>
<lpage>291</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0465-546X2019000400285&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0465-546X2019000400285&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0465-546X2019000400285&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Resumen: La enfermedad de Lyme es causada por la espiroqueta Borrelia Burgdoferi, que se transmite por la mordedura de la garrapata del género Ixodes. El diagnostico se realiza por ELISA y se confirma mediante Western blot o PCR. Una infección por Borrelia no solo desencadena una respuesta inmune humoral, sino que también activa la respuesta inmune celular medida por los linfocitos T, de allí la existencia del análisis Elispot-LTT, cual según la literatura científica tiene mayor especificidad y sensibilidad que incluso el Western blot. El presente caso de cuadro clínico atípico en un bombero con Enferemdad de Lyme y co-infección por Rickettsia conorii y Bartonella Heselae. Se declaró como enfermedad profesional dado que se adquirió en el ámbito laboral.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Abstract: Lyme disease is caused by the spirochete Borrelia Burgdoferi, which is transmitted by the bite of the tick of the genus Ixodes. The diagnosis is made by ELISA and confirmed by Western blot or PCR. A Borrelia infection not only triggers a humoral immune response, but also activates the cellular immune response measured by the T lymphocytes, hence the existence of the Elispot-LTT analysis, which according to the scientific literature has greater specificity and sensitivity than even the Western blot. The present case of an atypical clinical picture in a firefighter with Lyme disease and co-infection with Rickettsia conorii and Bartonella Heselae. It was declared as a occupational disease since it was acquired in the workplace.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Enfermedad de Lyme]]></kwd>
<kwd lng="es"><![CDATA[eritema crónico migrans]]></kwd>
<kwd lng="es"><![CDATA[medicina del trabjo]]></kwd>
<kwd lng="es"><![CDATA[exposición ocupacional]]></kwd>
<kwd lng="en"><![CDATA[Lyme disease]]></kwd>
<kwd lng="en"><![CDATA[Erithema chronicum migrans]]></kwd>
<kwd lng="en"><![CDATA[Occupational Medicine]]></kwd>
<kwd lng="en"><![CDATA[occupational exposure]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Portillo]]></surname>
<given-names><![CDATA[Aránzazu]]></given-names>
</name>
<name>
<surname><![CDATA[Santibáñez]]></surname>
<given-names><![CDATA[Sonia]]></given-names>
</name>
<name>
<surname><![CDATA[Oteo]]></surname>
<given-names><![CDATA[José A.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Enfermedad de Lyme]]></article-title>
<source><![CDATA[Enferm Infecc Microbiol Clin]]></source>
<year>2014</year>
<volume>32</volume>
<numero>Supl 1</numero>
<issue>Supl 1</issue>
<page-range>37-42</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wormser]]></surname>
<given-names><![CDATA[GP]]></given-names>
</name>
<name>
<surname><![CDATA[Dattwyler]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
<name>
<surname><![CDATA[Shapiro]]></surname>
<given-names><![CDATA[ED]]></given-names>
</name>
<name>
<surname><![CDATA[Halperin]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[Steere]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
<name>
<surname><![CDATA[Klempner]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America]]></article-title>
<source><![CDATA[Clin Infect Dis]]></source>
<year>2006</year>
<volume>43</volume>
<page-range>1089-134</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Stupica]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Lusa]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Ruzi-Sablji]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Cerar]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Strle]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Treatment of erythema migrans with doxycycline for 10 days versus 15 days]]></article-title>
<source><![CDATA[Clin Infect Dis]]></source>
<year>2012</year>
<volume>55</volume>
<page-range>343-50</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Oteo]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Blanco]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Ibarra]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[¿Podemos prevenir las enfermedades transmitidas por garrapatas?]]></article-title>
<source><![CDATA[Enferm Infecc Microbiol Clin]]></source>
<year>2001</year>
<volume>19</volume>
<page-range>509-13</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marques]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Chronic Lyme Disease: A Review]]></article-title>
<source><![CDATA[Infect Dis Clin N Am]]></source>
<year>2008</year>
<volume>22</volume>
<page-range>341-60</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pfister]]></surname>
<given-names><![CDATA[H-W]]></given-names>
</name>
<name>
<surname><![CDATA[Rupprecht]]></surname>
<given-names><![CDATA[TA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical aspects of neuroborreliosis and post-Lyme disease syndrome in adult patients]]></article-title>
<source><![CDATA[Int J Med Microbiol]]></source>
<year>2006</year>
<volume>296</volume>
<numero>^s40</numero>
<issue>^s40</issue>
<supplement>40</supplement>
<page-range>11-6</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Blaauw]]></surname>
<given-names><![CDATA[AAM]]></given-names>
</name>
<name>
<surname><![CDATA[Rijpkema]]></surname>
<given-names><![CDATA[SGT]]></given-names>
</name>
<name>
<surname><![CDATA[Kuiper]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Bijlsma]]></surname>
<given-names><![CDATA[JWJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Lyme disease: who should be tested and treated, and how?]]></article-title>
<source><![CDATA[Neth J Med]]></source>
<year>1997</year>
<volume>51</volume>
<page-range>154-62</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jin]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Roen]]></surname>
<given-names><![CDATA[DR]]></given-names>
</name>
<name>
<surname><![CDATA[Lehmann]]></surname>
<given-names><![CDATA[PV]]></given-names>
</name>
<name>
<surname><![CDATA[Kellermann]]></surname>
<given-names><![CDATA[GH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[An Enhanced ELISPOT Assay for Sensitive Detection of Antigen-Specific T Cell Responses to Borrelia burgdorferi]]></article-title>
<source><![CDATA[Cells]]></source>
<year>2013</year>
<volume>2</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>607-20</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nordberg]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Forsberg]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Nyman]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Skogman]]></surname>
<given-names><![CDATA[BH]]></given-names>
</name>
<name>
<surname><![CDATA[Nyberg]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Ernerudh]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Eliasson]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Ekerfelt]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Can ELISPOT Be Applied to A Clinical Setting as A Diagnostic Utility for Neuroborreliosis?]]></article-title>
<source><![CDATA[Cells]]></source>
<year>2012</year>
<volume>1</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>153-67</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nielsen]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[White]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Goodier]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Riley]]></surname>
<given-names><![CDATA[EM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Functional Significance of CD57 Expression on Human NK Cells and Relevance to Disease]]></article-title>
<source><![CDATA[Front Immunol]]></source>
<year>2013</year>
<volume>4</volume>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Klempner]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
<name>
<surname><![CDATA[Schmid]]></surname>
<given-names><![CDATA[CH]]></given-names>
</name>
<name>
<surname><![CDATA[Hu]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Steere]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
<name>
<surname><![CDATA[Johnson]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[McCloud]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Intralaboratory reliability of serologic and urine testing for Lyme disease]]></article-title>
<source><![CDATA[Am J Med]]></source>
<year>2001</year>
<volume>110</volume>
<page-range>217-9</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marques]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Brown]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Fleisher]]></surname>
<given-names><![CDATA[TA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Natural killer cell counts are not different between patients with post-Lyme disease syndrome and controls]]></article-title>
<source><![CDATA[Clin Vaccine Immunol]]></source>
<year>2009</year>
<volume>16</volume>
<page-range>1249-50</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Feder Jr]]></surname>
<given-names><![CDATA[HM]]></given-names>
</name>
<name>
<surname><![CDATA[Johnson]]></surname>
<given-names><![CDATA[BJ]]></given-names>
</name>
<name>
<surname><![CDATA[O'Connell]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Shapiro]]></surname>
<given-names><![CDATA[ED]]></given-names>
</name>
<name>
<surname><![CDATA[Steere]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
<name>
<surname><![CDATA[Wormser]]></surname>
<given-names><![CDATA[GP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A critical appraisal of "chronic Lyme disease" N Engl]]></article-title>
<source><![CDATA[J Med]]></source>
<year>2007</year>
<volume>357</volume>
<numero>14</numero>
<issue>14</issue>
<page-range>1422-30</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="">
<article-title xml:lang=""><![CDATA[Real Decreto 1299/2006, de 10 de noviembre, por el que se aprueba el cuadro de enfermedades profesionales en el sistema de la Seguridad Social y se establecen criterios para su notificación y registro]]></article-title>
<source><![CDATA[]]></source>
<year></year>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
