Millner M M, Müllegger R R, Spork K D, Stanek G
Infektionsabteilung der Universitäts-Kinderklinik, Wien, Austria.
Infection. 1991 Jul-Aug;19(4):273-8. doi: 10.1007/BF01644966.
Within 24 months in a consecutive series of 84 children with neurological symptoms indicative of Lyme borreliosis of the central nervous system (CNS) 45 seronegative children (group III), 17 seropositive (group II), and 22 children with specific Borrelia burgdorferi results in cerebrospinal fluid (CSF)-i.e. B. burgdorferi antibodies and/or intrathecally produced B. burgdorferi antibodies and/or positive B. burgdorferi culture in CSF were observed. The results show that intrathecally produced B. burgdorferi antibodies are the most important marker for the diagnosis of neuroborreliosis (with 71.4% positives) and B. burgdorferi cultivation directly from CSF may be successful in the earliest phase of the disease. Since each of the specific CSF parameters may be false negative in some cases, a careful synopsis of laboratory parameters was done. It shows that CSF protein and CSF cell values are higher in group I than in II or III. Neither can seronegativity exclude nor can seropositivity confirm the diagnosis of neuroborreliosis as in only 71% of group I serum B. burgdorferi antibodies were detected. In view of these aspects clinical and laboratory results are discussed.
在连续的84例有中枢神经系统（CNS）莱姆病伯氏疏螺旋体感染神经症状的儿童中，在24个月内，观察到45例血清阴性儿童（III组）、17例血清阳性儿童（II组）以及22例脑脊液（CSF）中有特定伯氏疏螺旋体检测结果的儿童，即脑脊液中存在伯氏疏螺旋体抗体和/或鞘内产生的伯氏疏螺旋体抗体和/或脑脊液中伯氏疏螺旋体培养阳性。结果表明，鞘内产生的伯氏疏螺旋体抗体是神经型莱姆病诊断的最重要标志物（阳性率为71.4%），直接从脑脊液中培养伯氏疏螺旋体在疾病的最早阶段可能成功。由于每种特定的脑脊液参数在某些情况下可能为假阴性，因此对实验室参数进行了仔细的综合分析。结果显示，I组的脑脊液蛋白和脑脊液细胞值高于II组或III组。血清阴性不能排除神经型莱姆病的诊断，血清阳性也不能确诊，因为I组中只有71%检测到血清伯氏疏螺旋体抗体。鉴于这些方面，对临床和实验室结果进行了讨论。
