The polymerase chain reaction in the diagnosis of Lyme neuroborreliosis

✍ Scribed by Dr. Andrew R. Pachner; Elizabeth Delaney

• Publisher: John Wiley and Sons
• Year: 1993
• Tongue: English
• Weight: 723 KB
• Volume: 34
• Category: Article
• ISSN: 0364-5134
• DOI: 10.1002/ana.410340407

✦ Synopsis

The polymerase chain reaction is sensitive and specific in the detection of defined D N A sequences and holds promise for diagnosing the presence of fastidious microorganisms in human infectious diseases. We developed a methodology for nested polymerase chain reaction and hybridization analysis of the cerebrospinal fluid using primers from a genomic Bowelia biwgdo~eri sequence and applied it to the cerebrospinal fluid (CSF) of patients suspected of having Lyme neuroborreliosis and other diseases. Polymerase chain reaction and hybridization demonstrated extremely high sensitivity for spirochetal DNA, and was highly specific, with a false-positivity rate of less than 3%. However, the results were negative or indeterminate in 54% of CSF samples from patients with definite or probable disease, indicating an absence, or extremely low level, of spirochetes or spirochetal D N A in a significant percentage of patients with Lyme neuroborreliosis. Polymerase chain reaction and hybridization of the CSF can thus be considered a useful adjunct in diagnosis, but its negativity does not rule out Lyme neuroborreliosis.