Avtor/Urednik     Ogrinc, Katarina; Lotrič-Furlan, Stanka; Maraspin-Čarman, Vera; Lusa, Lara; Cerar, Tjaša; Ružić-Sabljić, Eva; Strle, Franc
Naslov     Suspected early lyme neuroborreliosis in patients with erythema migrans
Tip     članek
Leto izdaje     2013
ISSN     Clinical infectious diseases : an official publication of the Infectious Diseases Society of America Med
Jezik     eng
Abstrakt     Background.To obtain data on patients with erythema migrans (EM) who have symptoms/signs suggesting nervous system involvement, and to compare epidemiologic, clinical and microbiologic findings in patients with and without cerebrospinal fluid (CSF) pleocytosis. Methods.Adult patients with EM and suspected early Lyme neuroborreliosis were included in this study. Results.Of 161 patients, 31 (19%) had elevated and 130 (81%) had normal CSF cell counts. In contrast to patients with normal CSF cell counts, those with pleocytosis: i) more often reported radicular pain and more often presented with meningeal signs but less frequently complained of malaise; ii) had larger EM skin lesions in spite of similar duration; iii) more commonly had B. garinii isolated from EM skin lesions (odds ratio for pleocytosis was 31 times higher in patients with established B. garinii skin infection in comparison to patients with other Borrelia species isolated from their EM skin lesion) and from CSF; and iiii) more frequently fulfilled microbiologic criteria for established borrelial infection of the central nervous system. The positive predictive value of pleocytosis for microbiologically proven borrelial infection of the central nervous system (defined by isolation of Borrelia from CSF and/or demonstration of intrathecal synthesis of borrelial antibodies) was 67.9%, whereas normal CSF white cell counts ruled out Lyme neuroborreliosis with a predictive value of 91.9%. Conclusions.Comparison of European patients with EM who had symptoms/signs suggesting early Lyme neuroborreliosis revealed several differences in the clinical presentation and in microbiologic test results according to CSF findings.
Proste vsebinske oznake     erythema migrans
Lyme neuroborreliosis
symptoms
erythema migrans
lajmska nevroborelioza
simptomi