Petrovic M, Vogelaers D, Van Renterghem L, Carton D, De Reuck J, Afschrift M
Department of Internal Medicine, University Hospital Ghent, Belgium.
Acta Clin Belg. 1998 Jun;53(3):178-83.
Difficulties in diagnosis of late stages of Lyme disease include low sensitivity of serological testing and late inclusion of Lyme disease in the differential diagnosis. Longer treatment modalities may have to be considered in order to improve clinical outcome of late disease stages. These difficulties clinical cases of Lyme borreliosis. The different clinical cases illustrate several aspects of late borreliosis: false negative serology due to narrow antigen composition of the used ELISA format, the need for prolonged antibiotic treatment in chronic or recurrent forms and typical presentations of late Lyme disease, such as lymphocytic meningo-encephalitis and polyradiculoneuritis.
莱姆病晚期诊断的困难包括血清学检测灵敏度低以及在鉴别诊断中较晚才考虑到莱姆病。为了改善疾病晚期的临床结局，可能需要考虑采用更长疗程的治疗方式。这些困难在莱姆疏螺旋体病的临床病例中有所体现。不同的临床病例说明了莱姆病晚期的几个方面：由于所用酶联免疫吸附测定（ELISA）形式的抗原成分狭窄导致血清学假阴性，慢性或复发性形式需要延长抗生素治疗，以及莱姆病晚期的典型表现，如淋巴细胞性脑膜脑炎和多发性神经根神经炎。
