Lyme diagnostic clues from university hospital
By Linda on Nov 30, 2010 in Infections | comments(0)
Excerpt:
In this study, we enrolled within 1 year 122 patients with
suspected chronic LNB. One hundred and fourteen patients had
previously tested positive for BB.
All patients had previously received antibiotic treatment. Each
patient received a clinical examination and measurement of
BB-specific antibodies. The diagnosis of neuroborreliosis was
made according to the national guidelines of the German Society
of Neurology. Nine patients had acute borreliosis. One of the
nine met the criteria of acute LNB. Of the remaining 113
patients, 85 patients underwent a lumbar puncture. Ten
seronegative subjects without lumbar puncture were also
considered. In 61.8% of these 95 patients the quality of life, of
sleep, mood, and anxiety were assessed.
Results: Of 95 patients, 25.3% had symptoms without a somatic
cause or evidence of borreliosis, 38.9% had a well-defined
illness unrelated to BB infection, and 29.5% suffered from
symptoms without a detectable somatic cause, displaying
antibodies against BB. Six patients were grouped as post-LNB
syndrome. Most common symptoms in all categories were arthralgia,
myalgia, dysaesthesia, depressive mood and chronic fatigue.
Conclusion:
Patients with persistent symptoms with elevated serum antibodies
against BB but without signs of cerebrospinal fluid inflammation
require further diagnostic examinations to exclude ongoing
infection and to avoid co-infections and other treatable
conditions (e.g. autoimmune diseases). One patient with acute
LNB, who was treated with ceftriaxone for 3 weeks suffered from
LNB with new headaches and persistent symptoms 6 months later.
These data should encourage further studies with new experimental
parameters. (c) 2010 The Author(s) European Journal of Neurology
(c) 2010 EFNS.
