Naesens R, Vermeiren S, Van Schaeren J, Jeurissen A
Department of Microbiology, GasthuisZusters Antwerpen, Antwerp, Belgium.
Acta Clin Belg. 2011 Jan-Feb;66(1):58-9. doi: 10.2143/ACB.66.1.2062517.
A 44-year-old man presented with visual field defects. Ophthalmoscopy revealed papilloedema of the left eye. Neuroborreliosis was suspected and serum was positively being tested using VIDAS* Lyme screen II (bioMerieux Vitek Inc). However, confirmatory testing using the Borrelia VlsE C6 titre was negative. Western Blotting on serum and cerebrospinal fluid could not confirm the possible diagnosis of neuroborreliosis. VDRL and TPPA testing was positive, and finally, the diagnosis of neurosyphilis was established. We subsequently screened our database on patients with positive VIDAS Lyme screening and negative confirmatory testing by Western blot, and found another 5 cases in which Lyme screening was false positive due to cross-reactivity with Treponema pallidum antibodies. Our data show that in patients with positive Lyme screening and negative confirmatory testing, performance of lues serology should be considered.
一名44岁男性出现视野缺损。眼底镜检查发现左眼视乳头水肿。怀疑为神经莱姆病，并使用VIDAS*莱姆筛查II（生物梅里埃维泰克公司）对血清进行检测，结果呈阳性。然而，使用伯氏疏螺旋体VlsE C6滴度进行的确诊检测为阴性。血清和脑脊液的western印迹法无法确诊神经莱姆病。性病研究实验室试验（VDRL）和梅毒螺旋体颗粒凝集试验（TPPA）检测呈阳性，最终确诊为神经梅毒。随后，我们在数据库中筛选了VIDAS莱姆筛查呈阳性但western印迹法确诊检测为阴性的患者，又发现了5例因与梅毒螺旋体抗体交叉反应导致莱姆筛查假阳性的病例。我们的数据表明，对于莱姆筛查呈阳性但确诊检测为阴性的患者，应考虑进行梅毒血清学检查。
