Péter O, Marini M, Blanc E, Dupuis G
Microbiologie clinique, Institut central des hôpitaux valaisans, Sion.
Schweiz Med Wochenschr. 1991 Feb 9;121(6):189-93.
The clinical diagnosis of Lyme borreliosis is easily established in the initial phase of the illness. Erythema chronicum migrans is pathognomonic of this infection. However, during further complications (neurological, cardiac or articular) the diagnosis is chiefly based on laboratory results. The detection of specific antibodies to B. burgdorferi is one of the effective means of confirming the diagnosis. Culture or isolation of this bacteria is not routinely performed due to its very low yield. In this article a case of serologically proved neuro-borreliosis is described and the methods of diagnosis are discussed. Intrathecal synthesis of antibodies observed in the cerebrospinal fluid of this patient and the specificity of serologic tests confirmed by Western-blot provide the diagnosis. However, the absence of locally synthesized antibodies in the cerebrospinal fluid is not sufficient to rule out neuro-borreliosis.
莱姆病的临床诊断在疾病初期很容易确立。慢性游走性红斑是这种感染的特征性表现。然而，在进一步出现并发症（神经、心脏或关节方面）时，诊断主要基于实验室检查结果。检测针对伯氏疏螺旋体的特异性抗体是确诊的有效手段之一。由于该细菌培养或分离的阳性率很低，通常不进行此项操作。本文描述了一例血清学确诊的神经型莱姆病病例，并讨论了诊断方法。该患者脑脊液中观察到的抗体鞘内合成以及经免疫印迹法证实的血清学检测特异性为诊断提供了依据。然而，脑脊液中缺乏局部合成的抗体并不足以排除神经型莱姆病。
