The aim of this study was to obtain data on patients with suspected early Lyme neuroborreliosis (LNB) and compare findings in patients with firm clinical diagnosis of LNB and those with possible LNB. Adult patients with EM and suspected early LNB with cerebrospinal fluid (CSF) examination were included in this prospective study. Considering clinical data and basic CSF findings, patients were classified as having firm clinical diagnosis of LNB (EM within 4 months before neurological symptoms, and CSF pleocytosis and/or peripheral facial palsy) or possible LNB (EM within 4 months before neurological symptoms but without CSF pleocytosis). Of 93 patients 34% were considered as having a firm clinical diagnosis of LNB and 66% possible LNB. In contrast to patients with possible LNB, those with firm clinical diagnosis of LNB had more often received adequate antibiotic therapy for EM before their presentation (47% versus 21%; p=0.0206), presented less frequently with still visible EM (53% versus 88.5%; p=0.0004), less often complained of malaise (41% versus 72%; p=0.0062) but more often reported radicular pain (47% versus 15%; p=0.0018), more frequently revealed borrelial IgG antibodies in serum and in CSF (41% versus 2%; p(0.0001) as well as intrathecal borrelial IgG synthesis (37.5% versus 2%; p(0.0001). Isolation rates of Borrelia burgdorferi s.l. from blood were 0% versus 3% (p=0.5437), from CSF 12.5% versus 0% (p=0.0123), and from skin 41% versus 36% (p=0.8805), respectively. Skin cultures were more often positive in patients with no previous antibiotic therapy than in already treated patients (47% versus 5.5%; p=0.0035) and in skin obtained from EM than from the site of past EM (43% versus 8%; p=0.0255). Improvement after antibiotic therapy was comparable in patients with CSF pleocytosis and in those without it.
B.06 Other
COBISS.SI-ID: 25668825We analyzed and compared the humoral immune response in serum and cerebrospinal fluid (CSF) in adult patients with clinically evident Lyme neuroborreliosis (LNB), patients with clinically suspected LNB and patients with TBE. Additionally, we wanted to compare the findings of two methods for detection of intrathecally synthesized borrelial antibodies: the IDEIA(TM) LNB test, and an approach based on the indirect chemiluminiscence immunoassay LIAISON(R). Borrelial IgM and IgG antibodies in sera of patients with clinically evident LNB were detected with at least one of the methods in 64.7% and 82.4% patients, respectively; the corresponding results in CSF were 64.7% and 58.8% patients. Intrathecal synthesis of borrelial IgM and/or IgG was found in 55.9% patients: IgM in 50%; IgG in 44.1%. Assessment of the humoral immune response in sera and CSF of patients with early LNB confirmed previous findings on the relationship between duration of illness and the proportion of patients with detectable response.
F.22 Improvement to existing health/diagnostic methods/procedures
COBISS.SI-ID: 26730713