ArticleInfection2025
Assessment of three criteria to establish borrelial infection in suspected lyme neuroborreliosis.
Article in Infection, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Cerebrospinal Fluid Profiles Across Clinical Manifestations of Early European Lyme Neuroborreliosis.Open forum infectious diseases · 2026Article
- Evaluating the Diagnostic Accuracy of Point-of-Care CXCL13 Measurements for Lyme Neuroborreliosis.Diagnostics (Basel, Switzerland) · 2026Article
- StreamliningJournal of medical microbiology · 2026Observational
- Borreliosis and Other Tick-Borne Diseases in the Northern and Southern Hemispheres.Microorganisms · 2025Article
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Authors and funding
10 authors.
Funding
Abstract
purposeDiagnosis of (European) Lyme neuroborreliosis has been based on clinical presentation, cerebrospinal fluid (CSF) pleocytosis and demonstration of intrathecal borrelial antibody synthesis (ITBAS) to document Borrelia burgdorferi s. l. INFECTION: It is not known if other criteria to document Borrelia infection may contribute to the diagnosis.
methodsWe compared the sensitivity of three individual criteria (ITBAS, CSF Borrelia culture, and the presence of erythema migrans [EM]) to confirm the diagnosis of early Lyme neuroborreliosis in 280 patients ≥ 15 years of age evaluated at a Lyme borreliosis outpatient clinic in Slovenia. The patients had either radicular pain of new onset or involvement of a cranial nerve but without radicular pain, each in conjunction with CSF pleocytosis. Evaluation was of patients who had each of the three confirmatory criteria assessed, and for whom at least one criterion was positive.
resultsAnalysis of 280 patients, 120 women and 160 men, median age 57 (range 15-84) years, revealed that ITBAS was the most frequently observed positive criterion (85.4%), followed by EM (52.9%), and by a positive CSF Borrelia culture (9.6%). Of the 280 patients, 154 (55%) met only one criterion (43.2% ITBAS only, 10.7% EM only, and 1.1% positive CSF culture only), whereas 42.1% met two criteria. Only 2.9% of patients were positive by all three criteria.
conclusionAlthough ITBAS was the most frequent criterion for confirmation for Borrelia infection, the presence of EM alone confirmed an additional 10.7% of patients and a positive CSF Borrelia culture alone added another 1.1%.
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