Zdravotn\u00ed probl\u00e9my p\u011btat\u0159icetilet\u00e9ho V\u00e1clava Mach\u00e1\u010dka za\u010daly loni na podzim pom\u011brn\u011b nen\u00e1padn\u011b \u2013 bolest\u00ed cel\u00e9ho t\u011bla a hore\u010dkou. Myslel si, \u017ee to bude vir\u00f3za nebo covid. Nebylo to ani jedno z toho. A\u017e po m\u011bs\u00edci \u00faporn\u00fdch bolest\u00ed hlavy a neustupuj\u00edc\u00ed \u00fanavy se dozv\u011bd\u011bl p\u0159\u00ed\u010dinu. M\u011bl boreli\u00f3zu.<\/p>\n\n\n\n
Lymesk\u00e1 boreli\u00f3za sv\u00fdm n\u00e1stupem skute\u010dn\u011b nejv\u00edce p\u0159ipom\u00edn\u00e1 b\u011b\u017enou ch\u0159ipku a vzhledem k aktu\u00e1ln\u00ed situaci padlo podez\u0159en\u00ed na koronavirus. \u201ePamatuji si, \u017ee jsem ten den hodn\u011b pracoval a ve\u010der u\u017e mi nebylo dob\u0159e, \u0161el jsem brzy sp\u00e1t,\u201c vypr\u00e1v\u00ed mlad\u00fd mu\u017e. \u201eByl jsem extr\u00e9mn\u011b unaven\u00fd a stra\u0161n\u011b m\u011b bolela hlava. R\u00e1no jsem m\u011bl hore\u010dku, bolelo m\u011b u\u017e cel\u00e9 t\u011blo, v\u0161echny klouby. Jeliko\u017e to bylo loni na podzim v dob\u011b, kdy znovu \u0159\u00e1dila epidemie covidu, poslala m\u011b l\u00e9ka\u0159ka na PCR test. Jen\u017ee ten byl negativn\u00ed.\u201c<\/p>\n\n\n\n
Znovu se vypravil k praktick\u00e9 l\u00e9ka\u0159ce a n\u00e1sledovaly odb\u011bry krve, v nich\u017e vy\u0161lo vy\u0161\u0161\u00ed CRP, a proto mu op\u011bt doporu\u010dila absolvovat PCR test na covid. Ten byl znovu negativn\u00ed. \u201eKdy\u017e jsem \u0159ekl, \u017ee nev\u00edm o tom, \u017ee bych m\u011bl kl\u00ed\u0161t\u011b, boreli\u00f3zu a kl\u00ed\u0161\u0165ovku vylou\u010dila a d\u00e1l pokra\u010dovala s testy na mononukle\u00f3zu a hepatitidy. Na v\u00fdsledky se \u010dekalo snad deset dn\u016f a m\u011b st\u00e1le tak \u0161\u00edlen\u011b bolela hlava, \u017ee to bylo k nevydr\u017een\u00ed. P\u0159i\u0161lo mi, \u017ee se to ka\u017ed\u00fd den zhor\u0161uje a \u00fanava st\u00e1le roste. Nakonec jsem pomalu nedok\u00e1zal doma vyj\u00edt schody. Kdy\u017e ani dal\u0161\u00ed vy\u0161et\u0159en\u00ed nic neprok\u00e1zala, odeslala m\u011b l\u00e9ka\u0159ka do neurologick\u00e9 ambulance v nemocnici. Cel\u00e9 to trvalo asi m\u011bs\u00edc. M\u011bs\u00edc nep\u0159est\u00e1vaj\u00edc\u00ed bolesti hlavy a \u0161\u00edlen\u00e9 \u00fanavy.\u201c<\/p>\n\n\n\n
V nemocnici V\u00e1clav podstoupil lumb\u00e1ln\u00ed punkci. P\u0159ed odb\u011brem mozkom\u00ed\u0161n\u00edho moku se prov\u00e1d\u00ed je\u0161t\u011b odb\u011br krve, kter\u00fd byl nakonec z\u00e1sadn\u00ed. \u201eV\u00fdsledky lumb\u00e1ln\u00ed punkce nic neprok\u00e1zaly, tak\u017ee to vypadalo, \u017ee jsem \u00fapln\u011b v po\u0159\u00e1dku. Po t\u00fddnu v\u0161ak p\u0159i\u0161ly v\u00fdsledky krve a l\u00e9ka\u0159ka mi ozn\u00e1mila, \u017ee m\u00e1m boreli\u00f3zu v akutn\u00edm stadiu. Okam\u017eit\u011b mi byla nasazena antibiotika na t\u0159i t\u00fddny. M\u011bl jsem sv\u00fdm zp\u016fsobem radost, \u017ee se kone\u010dn\u011b zjistila p\u0159\u00ed\u010dina m\u00fdch pot\u00ed\u017e\u00ed, proto\u017ee u\u017e jsem si za\u010d\u00ednal p\u0159ipadat jako hypochondr,\u201c p\u0159izn\u00e1v\u00e1 Mach\u00e1\u010dek.<\/p>\n\n\n\n
\u201eBoreli\u00f3za je extr\u00e9mn\u011b variabiln\u00ed nemoc se stovkami r\u016fzn\u00fdch variac\u00ed, napad\u00e1n\u00edm r\u016fzn\u00fdch org\u00e1n\u016f v r\u016fzn\u00e9m \u010dasov\u00e9m odstupu od vzniku n\u00e1kazy a s velmi nejednozna\u010dn\u00fdmi mo\u017enostmi pr\u016fkazu nemoci. P\u016fvodce nemoci je velmi p\u0159\u00edbuzn\u00fd p\u016fvodci syfilis, kter\u00e1 se po desetilet\u00ed naz\u00fdvala opi\u010d\u00ed nemoc\u00ed \u2013 je schopna napodobit stovky jin\u00fdch chorob a maskovat se za n\u011b. Boreli\u00f3za bohu\u017eel tuto schopnost od sv\u00e9 bl\u00edzk\u00e9 p\u0159\u00edbuzn\u00e9 trochu okoukala,\u201c vysv\u011btluje komplikace p\u0159i diagnostice neurolog a odborn\u00edk na boreli\u00f3zu Tom\u00e1\u0161 Bouzek.<\/p>\n\n\n\n
Um\u00ed se skr\u00fdt<\/p>\n\n\n\n
Nebezpe\u010d\u00ed p\u0159edstavuje boreli\u00f3za hlavn\u011b v tom, \u017ee jde ne v\u017edy, snadno a v\u010das odhalit. \u201eAsi nezn\u00e1m nemoc, ke kter\u00e9 by bylo vyvinuto tolik r\u016fzn\u00fdch diagnostick\u00fdch test\u016f, jejich spolehlivost jen vz\u00e1cn\u011b p\u0159esahuje osmdes\u00e1t procent a zdaleka ne v\u0161echny se b\u011b\u017en\u011b pou\u017e\u00edvaj\u00ed. Sta\u010d\u00ed pak jedno \u010di dv\u011b proveden\u00e1 vy\u0161et\u0159en\u00ed, kter\u00e1 vyjdou negativn\u011b, a m\u00e1 se za to, \u017ee boreli\u00f3za je vylou\u010dena. Ale n\u011bco vylou\u010dit je stokr\u00e1t t\u011b\u017e\u0161\u00ed ne\u017e n\u011bco dok\u00e1zat, na to se bohu\u017eel zapom\u00edn\u00e1,\u201c upozor\u0148uje neurolog.<\/p>\n\n\n\n
\u201eBorelie jsou z pohledu schopnosti p\u0159e\u017e\u00edvat a maskovat se vysoce inteligentn\u00ed. Um\u011bj\u00ed se schov\u00e1vat, uspat, vytvo\u0159it si biofilm a nepustit k sob\u011b antibiotika, hibernovat se a minim\u00e1ln\u011b metabolizovat, tak\u017ee se jich antibiotika nedotknou, nebo um\u011bj\u00ed obelh\u00e1vat imunitn\u00ed syst\u00e9m, p\u0159\u00edpadn\u011b jej nasm\u011brovat do autoimunitn\u00edch proces\u016f,\u201c \u0159\u00edk\u00e1 Tom\u00e1\u0161 Bouzek. U pozd\u011b zji\u0161t\u011bn\u00e9 nebo nel\u00e9\u010den\u00e9 boreli\u00f3zy m\u016f\u017ee nastat probl\u00e9m, kdy borelie zp\u016fsob\u00ed autoimunitn\u00ed posti\u017een\u00ed. Antibiotika pak v t\u011bchto p\u0159\u00edpadech podle neurologa \u010dasto ztr\u00e1cej\u00ed na v\u00fdznamu.<\/p>\n\n\n\n
\u201eMohu uv\u00e9st p\u0159\u00edpad pacienta, star\u0161\u00edho mu\u017ee, kter\u00fd krom \u00fanavy trp\u011bl hlavn\u011b \u00faporn\u00fdmi bolestmi trojklann\u00e9ho nervu. Osm let. Prod\u011blal v\u0161echno mo\u017en\u00e9 a \u00falevu na\u0161el a\u017e ve vysok\u00fdch d\u00e1vk\u00e1ch opioid\u016f a antiepileptik. Na nich byl utlumen s \u00fanosn\u00fdmi bolestmi \u0161est a p\u016fl roku, ne\u017e jsme p\u0159i zoufal\u00e9m vy\u0161et\u0159ov\u00e1n\u00ed prok\u00e1zali PCT testem boreli\u00f3zu v mozkom\u00ed\u0161n\u00edm moku. Nikdy \u017e\u00e1dn\u00e9 protil\u00e1tky nem\u011bl, v krvi ani v moku. Po p\u00e1r t\u00fddnech na l\u00e9\u010db\u011b vysadil opioidn\u00ed analgetika, bolesti zcela ustaly a oml\u00e1dl o v\u00edc ne\u017e deset let. Jde samoz\u0159ejm\u011b o raritu, ale ukazuje to pr\u00e1v\u011b na slo\u017eitost u\u017e jen stanoven\u00ed diagn\u00f3zy,\u201c podot\u00fdk\u00e1 Tom\u00e1\u0161 Bouzek.<\/p>\n\n\n\n
Kl\u00ed\u0161t\u011b jsem nem\u011bl<\/p>\n\n\n\n
V\u00e1clav Mach\u00e1\u010dek se ani po dobr\u00e1n\u00ed antibiotik nec\u00edtil dob\u0159e, st\u00e1le ho bolela hlava. \u201eVolal jsem volal na neurologii a tam mi \u0159ekli, \u017ee m\u00e1m p\u0159ij\u00edt, a\u017e bolest bude nesnesiteln\u00e1, a ani na kontrolu u\u017e k nim nemus\u00edm. V\u0161echno a\u0165 si \u0159e\u0161\u00edm s praktickou l\u00e9ka\u0159kou. Ta mi zase \u0159ekla, \u017ee nev\u00ed, co by se mnou m\u011bla d\u011blat, \u017ee si tohle mus\u00edm \u0159e\u0161it s neurology. Dokto\u0159i si m\u011b p\u0159ehazovali jak horkou bramboru. Postupn\u011b bolest hlavy odezn\u00edvala, ale celkov\u011b m\u011b dennodenn\u011b bolela hlava je\u0161t\u011b skoro \u010dtvrt roku. Nicm\u00e9n\u011b jsem m\u011bl \u0161t\u011bst\u00ed, \u017ee se boreli\u00f3za nesta\u010dila rozvinout a te\u010f u\u017e jsem v po\u0159\u00e1dku,\u201c uzav\u00edr\u00e1 V\u00e1clav.<\/p>\n\n\n\n
Podle neurologa v\u011bt\u0161in\u011b lid\u00ed v za\u010d\u00e1te\u010dn\u00edch stavech boreli\u00f3zy sta\u010d\u00ed l\u00e9\u010dba antibiotiky na p\u00e1r t\u00fddn\u016f. Nav\u00edc p\u0159ipou\u0161t\u00ed, \u017ee i kdyby v tomto p\u0159\u00edpad\u011b praktick\u00e1 l\u00e9ka\u0159ka nechala nabrat s\u00e9rologie na boreli\u00f3zu hned na za\u010d\u00e1tku, mohly by vyj\u00edt v\u00fdsledky negativn\u00ed. \u201eN\u011bkdy se protil\u00e1tky tvo\u0159\u00ed a\u017e za del\u0161\u00ed dobu, n\u011bkdy je jeden test nezachyt\u00ed v\u016fbec. Jedin\u00e9, co vid\u00edm jako velk\u00fd omyl, je ot\u00e1zka po kl\u00ed\u0161t\u011bti. I u kl\u00ed\u0161\u0165ov\u00e9 encefalitidy, kter\u00e1 prakticky nem\u00e1 jin\u00fd mechanismus p\u0159enosu ne\u017e kousnut\u00ed kl\u00ed\u0161t\u011btem a m\u00e1 kr\u00e1tkou inkuba\u010dn\u00ed dobu, v\u00ed o parazitovi jen m\u00e9n\u011b ne\u017e polovina nemocn\u00fdch. Tak\u017ee br\u00e1t kl\u00ed\u0161t\u011b za krit\u00e9rium vylu\u010duj\u00edc\u00ed nemoc je nesmysl, zvl\u00e1\u0161t\u011b kdy\u017e u boreli\u00f3zy je mo\u017en\u00fdch mechanism\u016f p\u0159enosu pops\u00e1no v\u00edc.<\/p>\n\n\n\n
Nicm\u00e9n\u011b i u tohoto p\u0159\u00edpadu je mo\u017en\u00e9, \u017ee kdyby na boreli\u00f3zu nikdo nep\u0159i\u0161el, tak za t\u0159i a\u017e p\u011bt m\u011bs\u00edc\u016f bolesti hlavy odezn\u00ed i bez pod\u00e1n\u00ed antibiotik a doty\u010dn\u00fd bude bez obt\u00ed\u017e\u00ed. Velk\u00e1 \u010d\u00e1st t\u011bch, kte\u0159\u00ed se potkali s boreli\u00f3zou se uzdrav\u00ed bez z\u00e1sahu l\u00e9ka\u0159e,\u201c podot\u00fdk\u00e1 neurolog Bouzek a poukazuje na v\u00fdzkum protil\u00e1tek na kl\u00ed\u0161\u0165ovou encefalitidu, kter\u00fd prob\u011bhl v Rakousku. V hodn\u011b promo\u0159en\u00fdch venkovsk\u00fdch oblastech m\u011blo protil\u00e1tky skoro osmdes\u00e1t procent populace a z toho jen velmi m\u00e1lo v\u011bd\u011blo o prod\u011bl\u00e1n\u00ed boreli\u00f3zy. U ostatn\u00edch prob\u011bhla jako divn\u00e1 ch\u0159ipka s bolestmi hlavy \u010di je\u0161t\u011b leh\u010deji.<\/p>\n\n\n\n
Nemoc nav\u017edy?<\/p>\n\n\n\n
Borelie mohou v t\u011ble z\u016fstat a nemusej\u00ed \u0161kodit, pokud jsou spr\u00e1vn\u011b uspan\u00e9 \u010di \u201ehl\u00eddan\u00e9\u201c v n\u011bjak\u00e9m bezpe\u010dn\u011b vymezen\u00e9m prostoru. \u201eJeden z l\u00e9ka\u0159sk\u00fdch vtip\u016f \u0159\u00edk\u00e1, \u017ee zdrav\u00fd \u010dlov\u011bk je jen nedostate\u010dn\u011b vy\u0161et\u0159en\u00fd. Pokud vymizej\u00ed p\u0159\u00edznaky a pacient se c\u00edt\u00ed dob\u0159e, m\u016f\u017ee mu b\u00fdt jedno, kolik mikrob\u016f mu v t\u011ble z\u016fst\u00e1v\u00e1. Jde jen o to, aby dob\u0159e fungoval imunitn\u00ed syst\u00e9m a dr\u017eel je v pat\u0159i\u010dn\u00fdch mez\u00edch. Ale samoz\u0159ejm\u011b pokud \u010dlov\u011bk prod\u011bl\u00e1 n\u011bjakou z\u00e1va\u017en\u011bj\u0161\u00ed formu boreli\u00f3zy, je rozumn\u00e9 p\u00e1r kontrol v\u010detn\u011b laboratorn\u00edch vy\u0161et\u0159en\u00ed s del\u0161\u00edm odstupem ud\u011blat, abychom m\u011bli p\u0159ehled a t\u0159eba zamezili dal\u0161\u00edm komplikac\u00edm,\u201c dod\u00e1v\u00e1 Bouzek.<\/p>\n\n\n\n
\u201eVzpom\u00edn\u00e1m si na jednu pacientku, mlad\u00e9 d\u011bv\u010de s kol\u00edsav\u00fdmi otoky kloub\u016f, kter\u00e9 se zklidnily po jednom p\u0159el\u00e9\u010den\u00ed ang\u00edny. V krvi \u017e\u00e1dn\u00e9 zn\u00e1mky boreli\u00f3zy nebyly, tak jsme se dohodli, \u017ee p\u0159ijde, a\u017e pokud j\u00ed n\u011bjak\u00fd kloub ote\u010de a p\u016fjde z n\u011bj dob\u0159e odebrat nitrokloubn\u00ed tekutina. Objevila se za necel\u00e9 dva roky, v krvi st\u00e1le nebylo nic, ale v kolenn\u00edm v\u00fdpotku jsme na\u0161li protil\u00e1tek i boreli\u00ed dostatek. Dostala antibiotika, kolega ortoped odstranil i nitrokloubn\u00ed v\u00fdstelku a m\u011bla pokoj p\u0159es deset let. I takhle m\u016f\u017ee prob\u011bhnout boreli\u00f3za,\u201c dopl\u0148uje neurolog.<\/p>\n\n\n\n
S vakc\u00ednou se nepo\u010d\u00edt\u00e1<\/p>\n\n\n\n
Dlouhodob\u011b se mluv\u00ed i o tom, \u017ee by proti boreli\u00f3ze m\u011bla b\u00fdt vyvinuta o\u010dkovac\u00ed l\u00e1tka. Podle neurologa Bouzka to ale nen\u00ed p\u0159\u00edli\u0161 re\u00e1ln\u00e9. \u201eZat\u00edm v\u0161echny ztroskotaly na tom, \u017ee m\u011bly mnoho vedlej\u0161\u00edch \u00fa\u010dink\u016f na imunitn\u00ed syst\u00e9m. To je u boreli\u00ed opravdu vyhl\u00e1\u0161en\u00e1 specialita. Tak\u017ee nepo\u010d\u00edt\u00e1m, \u017ee se n\u011b\u010deho takov\u00e9ho do\u017eiji.\u201c<\/p>\n\n\n\n
3 f\u00e1ze boreli\u00f3zy<\/p>\n\n\n\n
Prvn\u00ed f\u00e1ze nast\u00e1v\u00e1 asi dva a\u017e \u010dty\u0159i t\u00fddny po p\u0159enosu infekce do t\u011bla. \u010casto se na t\u011ble objevuje \u010derven\u00e1 skvrna, ale nen\u00ed to pravidlem. Krom\u011b toho m\u016f\u017ee m\u00edt \u010dlov\u011bk p\u0159\u00edznaky p\u0159ipom\u00ednaj\u00edc\u00ed ch\u0159ipku \u2013 bolest hlavy, t\u011bla a kloub\u016f, hore\u010dku.<\/p>\n\n\n\n
Druh\u00e1 f\u00e1ze p\u0159ich\u00e1z\u00ed po jednom a\u017e \u010dty\u0159ech m\u011bs\u00edc\u00edch od naka\u017een\u00ed a postihuje hlavn\u011b klouby, srdce a nervov\u00fd syst\u00e9m (nap\u0159. brn\u011bn\u00ed kon\u010detin, z\u00e1n\u011bt mozkom\u00ed\u0161n\u00edch blan, poruchy srde\u010dn\u00edho rytmu, otoky kloub\u016f).<\/p>\n\n\n\n
Bez l\u00e9\u010dby m\u016f\u017ee nemoc p\u0159ej\u00edt do t\u0159et\u00ed f\u00e1ze, kter\u00e1 m\u00edv\u00e1 celo\u017eivotn\u00ed n\u00e1sledky (nap\u0159. bolesti kloub\u016f, z\u00e1n\u011bt osrde\u010dn\u00edku, poruchy pam\u011bti a sp\u00e1nku).<\/p>\n\n\n\n
Alena Ben\u00ed\u0161kov\u00e1<\/p>\n\n\n\n
Den\u00edk<\/p>\n\n\n\n
https:\/\/www.denik.cz\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":" Zdravotn\u00ed probl\u00e9my p\u011btat\u0159icetilet\u00e9ho V\u00e1clava Mach\u00e1\u010dka za\u010daly loni na podzim pom\u011brn\u011b nen\u00e1padn\u011b \u2013 bolest\u00ed cel\u00e9ho t\u011bla a hore\u010dkou. Myslel si, \u017ee to bude vir\u00f3za nebo covid. […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":15672,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-37609","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/37609","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=37609"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/37609\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/15672"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=37609"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=37609"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=37609"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}