Although it is known that two-tier serologic testing for Lyme disease may be associated with false positive results on the IgM immunoblot, this problem has never been systematically studied in the clinical practice setting. In a retrospective investigation of patients referred to the private adult practice of an Infectious Diseases physician for possible for Lyme disease, 50 of 182 patients (27.5%, 95% CI: 21.1-34.6) were found to have a false positive IgM immunoblot. 78.0% of these patients had received unnecessary antibiotic therapy. False positive results were not restricted to any single commercial laboratory. Research on alternative testing strategies that eliminate the IgM immunoblot entirely is warranted.

AbstractA survey of 104 sexually active young females tested on on cervico-vaginal swabs showed that 26 of the females (25%) had vulvovaginal candidiasis with a species distribution of Candida isolates accounting for 13 (50%) with C. albicans, 6 (23%) with C. glabrata, 1 (4%) with C. krusei, and 6 (23%) with C. tropicalis. Of the 26 (25 %) subjects that were positive for VVC, 8 (7.8 %) were symptomatic and 18 (18.8 %) were asymptomatic. However, distribution among different age groups revealed an increase in the 23–27 age group. The comparative analysis of sensitivity of the given fungi to the number of antimycotic preparations used revealed the following: in fluconazole, 2 (7.8%) isolates were sensitive, 5 (19.2%) were susceptible and dose dependent, and 19 (73%) were resistant. For voriconazole, 4 (18.4%) isolates were sensitive, 6 (23.1%) were susceptible and dose dependent, and 16 (61.5%) were resistant. For nystatin, 5 (19.2%) isolates were sensitive, 10 (38.5%) were susceptible and dose dependent, and 11 (42.3%) were resistant. It appears that Candida isolates have a variable resistance response, but 19 (73%) had maximum resistance of the isolated fungi of the genus Candida to fluconazole. Therefore, further studies on the evaluation of combination therapy should be considered for a better outcome in treatment of vulvovaginal candidiasis.