We 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.
COBISS.SI-ID: 26730713
We compared two PCR methods and B. burgdorferi s.l. culture results from CSF and blood of patients with Lyme neuroborreliosis (LNB), suspected LNB, TBE and neurosurgical patients. Borrelial DNA was detected with at least one of the PCR methods in 11.9% of blood samples and 15.4% of CSF samples. The majority of strains were B. afzelii. Borreliae were isolated from 0.7% of blood samples and 3.2% of CSF samples. B. garinii was identified in all CSF isolates. There is a need for standardization of the methods for direct detection of borrelial infection. Appropriate control group has to be chosen.
COBISS.SI-ID: 24856281
This is a retrospective review of the medical files of patients diagnosed with borrelial lymphocytoma, Lyme neuroborreliosis, Lyme arthritis and acrodermatitis chronica atrophicans, for whom a borrelia blood culture was ordered. Borrelia burgdorferi sensu lato was isolated from the blood of 1/53 (1.9%) patients with borrelial lymphocytoma, 6/176 (3.4%) patients with Lyme neuroborreliosis, 1/13 (7.7%) patients with Lyme arthritis, and 3/200 (1.5%) patients with acrodermatitis chronica atrophicans. The time interval from the onset of symptoms attributed to Lyme borreliosis and the blood culture ranged from 1 day to )2 years (median 3.5 weeks). At the time of the blood culture, erythema migrans was present in 4/11(36.4%) borrelia blood culture-positive patients, i.e. in the patient with borrelial lymphocytoma, the patient with Lyme arthritis and the 2/6 patients with Lyme neuroborreliosis. Only two of these 11 (18.2%) patients had fever at the time of the blood culture. In European patients with Lyme borreliosis, borreliae can be cultured from the blood not only early in the course of the disease but also occasionally later during disease progression.
COBISS.SI-ID: 28168409
One hundred nineteen patients from New York State with erythema migrans caused by B. burgdorferi were compared with 116 patients from Slovenia with erythema migrans due to B. garinii infection. Patients with B. garinii infection were older, more often reported a tick bite, and developed larger lesions (median largest diameter: 18 and 14 cm, respectively;p=0.01) that more often had central clearing (61.2% compared with 35.3%; p(0.0001). Patients infected with B. burgdorferi, however, more often had systemic symptoms (68.9% vs. 37.1%; p(0.0001), including fatigue (p(0.0001), arthralgia (p=0.0003), myalgia (p(0.0001), headache (p=0.0008), fever and/or chills (p(0.0001), and stiff neck (p(0.0001), and more often had abnormal physical findings (57.1% compared with 11.2%; p(0.0001), such as fever (p=0.0002) or regional lymphadenopathy (p(0.0001). There was a trend for more patients with B. burgdorferi infection to have multiple erythema migrans skin lesions (13.4% compared with 5.2%; p=0.051), and among patients with multiple erythema migrans the number of lesions was greater in B. burgdorferi-infected patients (median: 5.5 compared with 2.0; p=0.006).
COBISS.SI-ID: 28828121