Maja Arnež

University of Ljubljana, Lubliano, Ljubljana, Slovenia

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Publications (8)14.74 Total impact

  • Maja Arnež · Eva Ružić-Sabljić
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    ABSTRACT: Investigation of demographic features, clinical characteristics, laboratory findings and post treatment course of the disease in children with borrelial lymphocytoma (BL). Between 2008 and 2014 we prospectively studied 33 children <15 years with untreated BL. Data on demographic and clinical features were collected by a questionnaire. Serological testing and Lyme borrelia blood cultures were performed. All patients were treated with recommended antibiotics. Patients were followed-up at least 3 months after inclusion into the study. Twenty-two boys and 11 girls, aged 2 to 13 (median, 5.5) years, fulfilled the inclusion criteria. A tick bite at the site of BL was recalled by 30%. The median incubation period was 10.5 (range, 1 - 38) days. The median duration of BL before the initial examination was 10 (range, 0 - 270) days. In 88% of patients BL was localized on ear lobe. The color/shape of BL was more often red (73%) and puffy (91%). Median size was 1.5 (range, 0.5 - 3) cm. The initial disease was mild in 82%. Associated symptoms were reported in 36% of patients. Concomitant solitary erythema migrans and meningitis were detected in 9% and 3% of patients, respectively. Serum borrelial antibodies were present in 40% of patients. In 7% B. afzelii was isolated from blood. Post treatment course of the disease revealed median duration of BL and systemic symptoms for 16 (range, 2 - 46) and 15 (range, 3 - 40) days, respectively. BL in children, treated with recommended antibiotics, is a mild disease with a good prognosis.
    No preview · Article · Aug 2015 · The Pediatric Infectious Disease Journal

  • No preview · Article · Jul 2015
  • Maja Arnež · Eva Ružić-Sabljić
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    ABSTRACT: Comparison of clinical efficacy and adverse effects of treatment with azithromycin and amoxicillin in children with solitary erythema migrans (EM). Consecutive patients < 15 years with untreated solitary EM referred to our institution 2002 - 2003 were included in thisunblinded prospective clinical study in which patients were alternatively treated with either azithromycin for 5 days or amoxicillin for 14 days. The efficacy of treatment of acute disease, development of minor and major manifestations of Lyme borreliosis (LB) and adverse effects of treatment were surveyed by follow-up visits during the first year after inclusion. Eighty-four patients received azithromycin and 84 amoxicillin. Pre-treatment characteristics in the two groups were comparable with the exception that patients in azithromycin group more often reported a tick bite at the site of later EM (69% versus 52%; p = 0.0400), had more often EM on the trunk (50% versus 26%; p = 0.0025), and reported longer duration of symptoms (median 3 versus 2 days; p = 0.0283). The post-treatment period revealed no significant differences between azithromycin and amoxicillin group including the duration of EM (median 3 days; p = 0.8984), and the appearance of minor (12% versus 21%; p = 0.2146) and major manifestations (2.6% in each group) of LB. Adverse effects of treatment were observed in 21% of patients treated with azithromycin and in 16% treated with amoxicillin, and the appearance of Jarish-Herxheimer's reaction was recorded in 7% and 15%, respectively (p = 0.1438). Comparison of azithromycin and amoxicillin for the treatment of children with solitary EM revealed comparable efficacy and adverse effects of treatment.
    No preview · Article · Jul 2015 · The Pediatric Infectious Disease Journal
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    ABSTRACT: A 13-year-old boy who presented with a red left eye, painful eye movement, blurred vision, photophobia and increased lacrimation, was diagnosed with 1-sided panuveitis with optic disk edema. Diagnostic work-up revealed borrelial antibodies in serum. Diagnosis of Lyme borreliosis was substantiated by demonstration of lymphocytic pleocytosis, intrathecal borrelial antibody synthesis, improvement after treatment with ceftriaxone and exclusion of other causes.
    No preview · Article · Mar 2015 · The Pediatric Infectious Disease Journal
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    ABSTRACT: To compare clinical effectiveness and safety of treatment with clarithromycin and amoxicillin in children with solitary erythema migrans (EM). Consecutive patients younger than 15 years, referred to our institution in 2004 and 2005 with previously untreated solitary erythema migrans, were included in this prospective study. Basic demographic features and clinical data were collected by means of a questionnaire. The efficiency of treatment of acute disease, development of later major and/or minor manifestations of Lyme borreliosis (LB), and side effects of treatment were surveyed by follow-up visits during the first year after the initiation of antibiotic treatment. The study included 68 female and 67 male children patients. The median age of the patients was 6.5 years. Out of 135 patients, 66 received clarithromycin and 69 amoxicillin. Before treatment no differences in demographic and clinical characteristics between the two groups were observed. The mean duration of EM after the beginning of treatment was 4 days in both groups. Associated symptoms during treatment were present for 7 days in patients treated with clarithromycin and for 10 days in patients receiving amoxicillin (p = 0.188). Minor manifestations of LB were identified in 11 (22.0 %) of 50 patients receiving clarithromycin, and in 16 (29.6 %) of 54 patients receiving amoxicillin who remained in the study during the entire observation period. Major manifestations of LB were not identified in any patient treated with clarithromycin, while there were 2 (3.7 %) patients with major manifestations of LB, who were receiving amoxicillin. Side effects of treatment were identified in 24.2 % patients receiving clarithromycin and 28.1 % patients treated with amoxicillin (p = 0.761). Presence of the Jarisch-Herxheimer's reaction at the beginning of treatment was comparable in both groups (10.6 % and 10.3 %;p = 0.823). Clarithromycin and amoxicillin are equally effective and safe in treatment of children with solitary EM and have comparable side effects.
    No preview · Article · Jul 2012 · Wiener klinische Wochenschrift
  • M. Arnež · E. Ružić-Sabljić
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    ABSTRACT: Background: To see how often the largest diameter of EM was less than 5 cm and to compare clinical features and course of the disease in patients with EM < 5 cm and EM ≥ 5 cm. Methods: 650 patients < 15 years of age referred to our institution from 1996 to 2004 with solitary EM were included in this prospective study. Clinical data were collected by questionnaire. Blood was taken and antibiotics were prescribed. Course of the disease was evaluated by follow-up for at least one year. Results: 81 patients had EM < 5 cm. At presentation, patients with EM < 5 cm had shorter incubation period, shorter duration of EM, less frequently ring-like EM and more frequently EM on the trunk and limbs. Patients with EM ≥ 5 cm more frequently presented with fatigue and regional lymphadenopathy. Laboratory findings were comparable. In both groups of patients Borrelia burgdorferi sensu lato bacteremia was found in 7.6 %. Post-treatment course of the disease was also comparable between the two groups. Conclusions: In 12.5 % of patients aged < 15 years with solitary EM the largest diameter of skin lesion was less than 5 cm. Despite the differences in clinical features at presentation, the course of the disease in patients with EM < 5 cm and EM ≥ 5 cm was comparable. Thus, from clinical point of view it is not wise to wait until the skin lesion enlarges to 5 cm in diameter, but start appropriate treatment at once to avoid dissemination of borrelial infection.
    No preview · Article · Jun 2012
  • Maja Arnež · Eva Ružić-Sabljić
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    ABSTRACT: To establish the frequency and characteristics of Borrelia burgdorferi sensu lato bacteremia in Slovenian children with solitary and multiple erythema migrans, 1164 patients were included in this prospective study. Bacteremia was established in 11.4% of all patients, 15.8% of patients with multiple erythema migrans, and in 7.6% of patients with solitary erythema migrans. Bacteremia can be detected in children, with untreated erythema migrans, up to 39 days after the onset of skin rash.
    No preview · Article · Jun 2011 · The Pediatric Infectious Disease Journal
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    ABSTRACT: We present a case of clinically overt acute myositis associated with the initial phase of tick-borne encephalitis in a ten-year-old boy. The diagnosis of the disease was confirmed by detection of tick-borne encephalitis virus RNA in blood prior to the development of serum specific antibodies and the second phase of the disease.
    No preview · Article · Jun 2011 · Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology

Publication Stats

8 Citations
14.74 Total Impact Points

Institutions

  • 2015
    • University of Ljubljana
      • Institute of Microbiology and Immunology
      Lubliano, Ljubljana, Slovenia
  • 2011-2012
    • Ljubljana University Medical Centre
      • Department of Neurology
      Lubliano, Ljubljana, Slovenia