To test or not to test? Laboratory support for the diagnosis of Lyme borreliosis: a position paper of ESGBOR, the ESCMID study group for Lyme borreliosis

Dessau, Ram Benny; Dam, Alje P. van; Fingerle, Volker; Gray, Jeremy; Hovius, Joppe W.; Kp, Hunfeld; Jaulhac, B.; Kahl, Olaf; Kristoferitsch, Wolfgang; Lindgren, Per-Eric; Markowicz, Mateusz; Mavin, Sally; Ornstein, Katharina; Rupprecht, Tobias A.; Stanek, Gerold; Strle, Franc

doi:10.1016/j.cmi.2017.08.025

Cited by 118 publications

(150 citation statements)

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“…Finally, in 128 of 199 positive samples, the IgG antibodies towards the p18 of B. afzelii, an antigen associated with late disseminated LB [4], were over the detection limit in the recom-Bead IgG 2.0 bead immunoassay Supplementary Material Fig. S1, which is in contrast to the results of the 2011 samples, where no samples yielded the 'over' result with this antigen.…”

Section: Discussionmentioning

confidence: 87%

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Seroprevalence of Lyme borreliosis in Finland 50 years ago

Cuellar

Dub

Sane

et al. 2020

Clinical Microbiology and Infection

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Editor: S.J. Cutler Keywords:Europe Lyme borreliosis Seroprevalence historical risk factors a b s t r a c t Objectives: Lyme borreliosis (LB) is a tick-borne infection common in Europe. In Finland, the LB seroprevalence in the healthy population was 3.9% in 2011. While the present-day seroprevalence of LB is well characterized in several European areas, there are no studies on the seroprevalence of LB before the description of the infection in the late 1970s. Methods: We used a subset of historical serum samples (n ¼ 994) collected during the Finnish Mobile Clinic Health Survey, a nationwide cross-sectional health survey of the 1960s and 1970s. All samples were screened with Borrelia burgdorferi whole-cell sonicate IgG ELISA. The seropositivity of the samples was further confirmed by the C6 peptide ELISA and recomBead IgG 2.0 bead immunoassay. The association of LB seropositivity with risk factors and with self-reported diseases and symptoms relating to disseminated LB were analysed by logistic regression. Results: B. burgdorferi IgGs were detected in 199 of 994 analysed samples; hence, the overall seroprevalence was 20.0% (95% confidence interval: 17.6e22.6). The highest seroprevalence was observed in persons aged 50 years (165/696), in those currently not working (92/383), and in the regions of South and Central Finland (91/226 and 27/88, respectively). Further, perception of feeling unhealthy (129/197 versus 412/794) was higher among LB-seropositive individuals compared to LB-seronegative participants. Conclusion: LB seroprevalence was considerably higher in Finland in the late 1960s and early 1970s than in 2011. This result questions the perception of an unprecedentedly high LB seroprevalence in presentday Europe.

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Section: Discussionmentioning

confidence: 87%

“…Serology is the standard laboratory method used to support the diagnosis of patients with disseminated LB [3,4]. Immunoglobulin (Ig) M and IgG antibodies towards Borrelia are detected in serum of patients within 6e8 weeks after the infection [4]. In the disseminated form of LB, over 99% patients have detectable antibodies [5].…”

Section: Introductionmentioning

confidence: 99%

Seroprevalence of Lyme borreliosis in Finland 50 years ago

Cuellar

Dub

Sane

et al. 2020

Clinical Microbiology and Infection

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“…Patients with 3-6 points and 7-12 points (the moderate and high-risk groups, respectively) are subjected to serological tests: using an ELISA test for a search for anti-LD IgM and IgG antibodies and a Western blot test for confirmation (22). The results of the serological tests must be interpreted in the light of the patient's clinical condition and of the course of the disease (23). A diagnosis of Lyme myocarditis is very complicated and other tests are needed to confirm the final diagnosis:…”

Section: Diagnosis Of Lyme Myocarditismentioning

confidence: 99%

“…• Molecular testing for pathogen DNA detection is recommended only in certain situations, such as atypical LD manifestations in the skin or suspected Lyme arthritis (23).…”

Section: Diagnosis Of Lyme Myocarditismentioning

confidence: 99%

Lyme disease and heart transplantation: presentation of a clinical case and a literature review

Pilypas¹,

Raišelienė²,

Valaikienė³

2020

AML

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Background. Lyme disease, the most common anthropozoonosis, is a transmissible natural focal infection affecting various organs and systems. Also known as Lyme borreliosis, it is caused by Borrelia spirochetes, which are distributed by ticks of the genus Ixodes. Early diagnosis is difficult due to frequent occurrence of atypical symptoms, unnoticed tick bites, the absence of migratory erythematous lesions, and symptoms occurring during the nontick season. If not diagnosed and treated in time, dissemination of the infection occurs and various complications develop since borrelias damage not only the skin but also the nervous system, joints, and, in rare cases, the heart and eyes. Materials and methods. This article presents a clinical case of Lyme borreliosis-induced myocarditis, which led to the development of dilated cardiomyopathy and, consequently, urgent cardiac transplantation. According to our data, this is one of the first described cases of this complication in the world. Results and conclusions. When diagnosed in time and treated properly, the prognosis of Lyme myocarditis is usually good. In most cases, the atrioventricular block disappears within 1–2 weeks of antibiotic treatment and the implantation of a temporary pacemaker is rarely needed. In those rare cases of a chronic Borrelia burgdorferi infection, dilated cardiomyopathy may develop; thus if a sudden atrioventricular block occurs, the physician should be vigilant and perform the necessary tests to exclude the diagnosis of Lyme disease.

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“…The latter is identified by intrathecal synthesis of Borrelia-specific antibodies, expressed as the antibody index (cerebrospinal fluid/serum index). A narrative review of recommendations on when to request laboratory testing for Lyme borreliosis has been published recently in Clinical Microbiology and Infection [4].…”

mentioning

confidence: 99%