ArticleBMC infectious diseases2010
Utilization of serology for the diagnosis of suspected Lyme borreliosis in Denmark: survey of patients seen in general practice.
Article in BMC infectious diseases, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Differentiating Lyme arthritis: a case-based review.Rheumatology international · 2024Pooled it
- The diagnostic accuracy of serological tests for Lyme borreliosis in Europe: a systematic review and meta-analysis.BMC infectious diseases · 2016Pooled it
- An intervention in general practice to improve the management of Lyme borreliosis in Denmark.European journal of public health · 2022Trial
- Resident primary care practitioners' awareness and handling of zoonotic diseases: an explorative online survey in the Hameln-Pyrmont district, Lower Saxony, Germany.BMC primary care · 2025Article
- Article
- A serosurvey examining exposure toIJID regions · 2024Article
- Prevalence and factors associated with a prescription of a Lyme borreliosis serology for erythema migrans diagnosis in general practice: a study from the French sentinel network, 2009-2020.BMC primary care · 2023Article
- ClassicalLife (Basel, Switzerland) · 2023Article
- Utility ofFrontiers in cellular and infection microbiology · 2023Article
- Serodiagnosis of Lyme borreliosis-is IgM in serum more harmful than helpful?European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2021Observational
- Evaluation of factors influencing tick bites and tick-borne infections: a longitudinal study.Parasites & vectors · 2021Article
- Serological testing for Lyme Borreliosis in general practice: A qualitative study among Dutch general practitioners.The European journal of general practice · 2020Article
- Commercial test kits for detection of Lyme borreliosis: a meta-analysis of test accuracy.International journal of general medicine · 2016Article
- Study of a Cohort of 1,886 Persons To Determine Changes in Antibody Reactivity to Borrelia burgdorferi 3 Months after a Tick Bite.Clinical and vaccine immunology : CVI · 2015Article
- Borrelia burgdorferi sensu lato serology in the Netherlands: guidelines versus daily practice.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2014Article
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5 authors.
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Abstract
backgroundSerological testing for Lyme borreliosis (LB) is frequently requested by general practitioners for patients with a wide variety of symptoms.
methodsA survey was performed in order to characterize test utilization and clinical features of patients investigated for serum antibodies to Borrelia burgdorferi sensu lato. During one calendar year a questionnaire was sent to the general practitioners who had ordered LB serology from patients in three Danish counties (population 1.5 million inhabitants). Testing was done with a commercial ELISA assay with purified flagella antigen from a Danish strain of B. afzelii.
resultsA total of 4,664 patients were tested. The IgM and IgG seropositivity rates were 9.2% and 3.3%, respectively. Questionnaires from 2,643 (57%) patients were available for analysis. Erythema migrans (EM) was suspected in 38% of patients, Lyme arthritis/disseminated disease in 23% and early neuroborreliosis in 13%. Age 0-15 years and suspected EM were significant predictors of IgM seropositivity, whereas suspected acrodermatitis was a predictor of IgG seropositivity. LB was suspected in 646 patients with arthritis, but only 2.3% were IgG seropositive. This is comparable to the level of seropositivity in the background population indicating that Lyme arthritis is a rare entity in Denmark, and the low pretest probability should alert general practitioners to the possibility of false positive LB serology. Significant predictors for treating the patient were a reported tick bite and suspected EM.
conclusionsA detailed description of the utilization of serology for Lyme borreliosis with rates of seropositivity according to clinical symptoms is presented. Low rates of seropositivity in certain patient groups indicate a low pretest probability and there is a notable risk of false positive results. 38% of all patients tested were suspected of EM, although this is not a recommended indication due to a low sensitivity of serological testing.
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