Get your own Free Home PageLyme disease is a serious bacterial infection caused by a tick bite and affects humans and animals.
This page contains citations and highlighted extracts for medical and scientific articles from the National Institutes of Health (NIH), National Library of Medicine (NLM) MEDLINE database about seronegative or false negative Lyme disease. Citations are sorted by date within categories.
Note: The abstracts and annotations below were gleaned from citations found by the following link:
MEDLINE - seronegative or false negative AND Lyme disease - 125 citations found on 14 Dec 99
The categories below are not mutually exclusive. For instance, the category "antibodies binding with bacteria" is very closely related to the category "inadequate tests" - tests which break down immune complexes and measure resultant antibodies sometimes detect Lyme disease antibodies where other "conventional" tests have failed.
Definitions and comment:
TITLE:
Guidelines for the clinical diagnosis of Lyme disease [letter; comment]
AUTHORS:
Liegner KB; Kochevar J
SOURCE:
Ann Intern Med 1998 Sep 1;129(5):422; discussion 423
COMMENT:
Comment on: Ann Intern Med 1997 Dec 15;127(12):1106-8
"[No abstract available.]"
TITLE:
[Acute Borrelia infection. Unilateral papillitis as isolated clinical
manifestation]
AUTHORS:
Pradella SP; Krause A; Muller A
AUTHOR
AFFILIATION:
Klinik und Poliklinik fur Augenheilkunde, Martin-Luther-Universitat, Halle-Wittenberg.
SOURCE:
Ophthalmologe 1997 Aug;94(8):591-4
"Seronegative values in subjects strongly suspected of having Lyme disease do not necessarily exclude the diagnosis of Lyme disease."
TITLE:
Borrelia burgdorferi infection: clinical diagnostic techniques.
AUTHORS:
Coyle PK
AUTHOR
AFFILIATION:
Department of Neurology, School of Medicine, State University of
New York at Stony Brook 11794, USA.
SOURCE:
Immunol Invest 1997 Jan-Feb;26(1-2):117-28
"Most laboratory testing for Lyme disease relies on serologic documentation of prior exposure to the agent. However, such testing detects asymptomatic infections, and does not detect seronegative infections."
TITLE:
Formation and cultivation of Borrelia burgdorferi spheroplast-L-form
variants [published erratum appears in Infection 1996 Jul-Aug;24(4):335]
AUTHORS:
Mursic VP; Wanner G; Reinhardt S; Wilske B; Busch U; Marget W
AUTHOR
AFFILIATION:
Max von Pettenkofer-Institut, Ludwig-Maximilians-Universitat Munchen,
Germany.
SOURCE:
Infection 1996 May-Jun;24(3):218-26
"With regard to the polyphasic course of Lyme borreliosis, these forms without cell walls can be a possible reason why Borrelia survive in the
organism for a long time (probably with all beta-lactam antibiotics) [corrected] and the cell-wall-dependent antibody titers disappear and emerge after reversion."
TITLE:
Azithromycin compared with amoxicillin in the treatment of erythema migrans. A double-blind, randomized, controlled trial [see comments]
AUTHORS:
Luft BJ; Dattwyler RJ; Johnson RC; Luger SW; Bosler EM; Rahn DW;
Masters EJ; Grunwaldt E; Gadgil SD
AUTHOR
AFFILIATION:
Department of Medicine, State University of New York at
Stony Brook, NY 11794-8160 USA.
SOURCE:
Ann Intern Med 1996 May 1;124(9):785-91
COMMENT:
Comment in: Ann Intern Med 1997 Mar 1;126(5):408; discussion 408-9
"For patients treated with azithromycin, development of an antibody response increased the possibility of achieving a complete response
(81% of seropositive patients achieved a complete response compared with 60% of seronegative patients; P=0.043)... Fifty-seven percent of patients who had relapse were seronegative at the time of relapse... Most patients were seronegative for Borrelia burgdorferi at the time of
presentation with erythema migrans (65%) and at the time of relapse (57%)."
TITLE:
Physician preferences in the diagnosis and treatment of Lyme disease in the United States.
AUTHORS:
Ziska MH; Donta ST; Demarest FC
AUTHOR
AFFILIATION:
Lyme Disease Foundation, Hartford, Connecticut 06103-2610, USA.
SOURCE:
Infection 1996 Mar-Apr;24(2):182-6
"To assess physician preferences in the diagnosis and treatment of Lyme disease, questionnaires were sent to physicians in various Lyme disease endemic areas in the U.S. Seventy-eight responses were analyzed. Both ELISA and Western blot were ordered by 86% of responders. Fifty percent of responders believed that 25% or more of patients who have Lyme disease were seronegative."
TITLE:
Kill kinetics of Borrelia burgdorferi and bacterial findings in
relation to the treatment of Lyme borreliosis [published erratum
appears in Infection 1996 Mar-Apr;24(2):169]
AUTHORS:
Preac Mursic V; Marget W; Busch U; Pleterski Rigler D; Hagl S
AUTHOR
AFFILIATION:
Max v. Pettenkofer Institut, Ludwig-Maximilians-Universitat
Munchen, Germany.
SOURCE:
Infection 1996 Jan-Feb;24(1):9-16
"The patients had clinical disease with or without diagnostic antibody titers to B. burgdorferi."
TITLE:
Early disseminated Lyme disease: cardiac manifestations.
AUTHORS:
Sigal LH
AUTHOR
AFFILIATION:
Division of Rheumatology, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick, USA.
SOURCE:
Am J Med 1995 Apr 24;98(4A):25S-28S; discussion 28S-29S
"Lyme carditis should be considered in the proper clinical setting with appropriate use of diagnostic tests, recalling that patients with carditis early in Lyme disease may be seronegative..."
TITLE:
[The humoral immunological response of patients with Lyme disease]
AUTHORS:
Skripnikova IA; Anan'eva LP; Barskova VG; Ushakova MA
SOURCE:
Ter Arkh 1995;67(11):53-6
"Both acute and chronic borreliosis can be seropositive or seronegative."
TITLE:
[Neurologic manifestations of Lyme borreliosis in children]
AUTHORS:
Millner M
AUTHOR
AFFILIATION:
Universitats-Kinderklinik, Graz.
SOURCE:
Wien Med Wochenschr 1995;145(7-8):178-82
"Our own observations in children which suffered from an acute neuroborreliosis (NB) showed the following:...3) Indeed, there is a seronegative NB also in children."
TITLE:
[The neurological syndromes in Lyme disease in children]
AUTHORS:
Badalian LO; Kravchuk LN; Sergovskaia VD; Belousova VS; Minina AP
SOURCE:
Zh Nevropatol Psikhiatr Im S S Korsakova 1994;94(3):3-6
"Two clinicoimmunological LD variants were verified: seropositive and
seronegative mite-borne Borrelia infection with typical clinical
manifestations."
TITLE:
Seronegative Lyme disease.
AUTHORS:
Steere AC
AUTHOR
AFFILIATION:
New England Medical Center, Tufts University School of Medicine, Boston.
SOURCE:
JAMA 1993 Sep 15;270(11):1369
"[No abstract available]"
TITLE:
Difficulties with Lyme serology.
AUTHORS:
Banyas GT
SOURCE:
J Am Optom Assoc 1992 Feb;63(2):135-9
"Lyme disease is a multisystem infection characterized by dermatologic, neurologic, and arthritic findings. Like syphilis, Lyme borreliosis may imitate several other infectious and non-infectious diseases. Diagnosis is dependent on a reliable history (if available), clinical findings, and blood serology findings. A major problem has been seronegativity in persons possessing the disease (false negatives). At present, seronegativity in persons strongly suspected of having Lyme disease does not necessarily exclude the diagnosis of Lyme disease. The clinician
must recognize this in patients who may have Lyme disease or a recurrence of the disease."
TITLE:
Lyme borreliosis in Texas.
AUTHORS:
Goldings AS; Taylor JP; Rawlings J
AUTHOR
AFFILIATION:
Department of Health, Austin, TX 78756.
SOURCE:
Tex Med 1991 Sep;87(9):62-6
"In the absence of the pathognomonic skin lesion, determination of antibody response is currently the most practical laboratory aid in diagnosis. However, clinical judgement is necessary for the correct interpretation of laboratory results because false-positive and false- negative results are common."
TITLE:
Tullio phenomenon and seronegative Lyme borreliosis [letter]
AUTHORS:
Nields JA; Kueton JF
SOURCE:
Lancet 1991 Jul 13;338(8759):128-9
"[No abstract available]"
TITLE:
Lyme borreliosis of central nervous system (CNS) in children: a diagnostic challenge.
AUTHORS:
Millner MM; Mullegger RR; Spork KD; Stanek G
AUTHOR
AFFILIATION:
Infektionsabteilung der Universitats-Kinderklinik, Wien, Austria.
SOURCE:
"Infection 1991 Jul-Aug;19(4):273-8
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."
TITLE:
Seronegative Lyme disease and transitory atrioventricular block [letter; comment]
AUTHORS:
Pikelj F; Strle F; Mozina M
SOURCE:
Ann Intern Med 1989 Jul 1;111(1):90
COMMENT:
Comment on: Ann Intern Med 1989 Mar 1;110(5):339-45
"[No abstract available]"
TITLE:
Seronegative Lyme disease [letter; comment]
SOURCE:
N Engl J Med 1989 May 11;320(19):1279-80
COMMENT:
Comment on: N Engl J Med 1988 Dec 1;319(22):1141-6
"[No authors, no abstract, no antibodies!]"
TITLE:
Seronegative neuroborreliosis [letter]
AUTHORS:
Guy EC; Turner AM
SOURCE:
Lancet 1989 Feb 25;1(8635):441
"[No abstract available - letter]"
TITLE:
[Lyme borreliosis--a possible cause of atrioventricular block]
AUTHORS:
Wunderlich E; Thess G; Hetze A; Witzleb W; Schmidt PK
AUTHOR
AFFILIATION:
Leitklinik fur Herz-Kreislauf-Krankheiten des Bezirkes, Dresden.
SOURCE:
Z Kardiol 1988 Apr;77(4):256-7
"Eight cases of Lyme borreliosis of clinical certainty with carditis are reported. In six patients, AV-blocks were predominant, two patients had a myopericarditis. Six acute cases were seropositive, but one case remained seronegative. The titer was border-line in that patient, who was studied 4 years after the acute disease. A Lyme carditis should be considered in each case, in which AV-blocks appear acutely."
TITLE:
Lyme disease. A neuro-ophthalmologic view.
AUTHORS:
MacDonald AB
AUTHOR
AFFILIATION:
Department of Pathology, Southampton Hospital, NY 11968.
SOURCE:
J Clin Neuroophthalmol 1987 Dec;7(4):185-90
"Potential pitfalls in the diagnosis of Lyme disease with an emphasis on false negative serology and currently available diagnostic modalities are presented."
TITLE:
Lyme borreliosis--a review of the late stages and treatment of four
cases.
AUTHORS:
Petrovic M; Vogelaers D; Van Renterghem L; Carton D; De Reuck J; Afschrift M
AUTHOR
AFFILIATION:
Department of Internal Medicine, University Hospital Ghent, Belgium.
SOURCE:
Acta Clin Belg 1998 Jun;53(3):178-83
"The different clinical cases illustrate several aspects of late borreliosis: false negative serology due to narrow antigen composition of the used ELISA format,..."
TITLE:
Enzyme-linked immunosorbent assays with recombinant internal flagellin fragments derived from different species of Borrelia burgdorferi sensu lato for the serodiagnosis of Lyme neuroborreliosis.
AUTHORS:
Hauser U; Wilske B
AUTHOR
AFFILIATION:
Max von Pettenkofer-Institut fur Hygiene und Medizinische Mikrobiologie, Ludwig-Maximilians-Universitat Munchen, Germany.
hauser@m3401.mpk.med.uni-muenchen.de
SOURCE:
Med Microbiol Immunol (Berl) 1997 Oct;186(2-3):145-51
"The serodiagnosis of early Lyme neuroborreliosis is hampered by false negative results and one of the reasons could be the heterogeneity of strains of Borrelia burgdorferi sensu lato... The differences in immune reactivity of patients sera (due to strain heterogeneity?) seems to have more influence on the results of an assay based on a single antigen than on a whole-cell-based test."
TITLE:
Tetracycline therapy for chronic Lyme disease.
AUTHORS:
Donta ST
AUTHOR
AFFILIATION:
Boston University Medical Center and Boston Veterans Affairs Medical Center, Massachusetts 02118, USA.
SOURCE:
Clin Infect Dis 1997 Jul;25 Suppl 1:S52-6
"Treatment outcomes for seronegative patients (20% of all patients) were similar to those for seropositive patients. Western immunoblotting showed reactions to one or more Borrelia burgdorferi-specific proteins for 65% of the patients for whom enzyme-linked immunosorbent assays were negative."
TITLE:
GlpQ: an antigen for serological discrimination between relapsing fever and Lyme borreliosis.
AUTHORS:
Schwan TG; Schrumpf ME; Hinnebusch BJ; Anderson DE Jr; Konkel ME
AUTHOR
AFFILIATION:
Laboratory of Microbial Structure and Function, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana 59840, USA.
SOURCE:
J Clin Microbiol 1996 Oct;34(10):2483-92
"Tick-borne relapsing fever is caused by numerous Borrelia species maintained in nature by Ornithodoros tick-mammal cycles. Serological confirmation is based on either an immunofluorescence assay or an enzyme-linked immunosorbent assay using whole cells or sonicated Borrelia hermsii as the antigen. However, antigenic variability of this bacterium's outer surface proteins and antigens shared with the Lyme disease spirochete (B. burgdorferi), may cause both false-negative and false-positive results when testing sera of patients suspected to have either relapsing fever or Lyme disease. ...Serum samples from humans and mice infected with B. hermsii or other species of relapsing fever spirochetes contained antibodies recognizing GlpQ, whereas serum samples from Lyme disease and syphilis patients were nonreactive. Serologic tests based on this antigen will identify people exposed previously to relapsing fever spirochetes and help clarify the distribution of relapsing fever and Lyme disease in situations in which the occurrence of their causative agents is uncertain."
TITLE:
Lyme disease: laboratory diagnosis of infected and vaccinated symptomatic dogs.
AUTHORS:
Jacobson RH; Chang YF; Shin SJ
AUTHOR
AFFILIATION:
Diagnostic Laboratory, College of Veterinary Medicine, Cornell University, Ithaca, NY 14852-5786, USA.
SOURCE:
Semin Vet Med Surg (Small Anim) 1996 Aug;11(3):172-82
"Serology can be a very useful aid in the diagnosis of Lyme disease, but it requires that the assays used have been subjected to rigorous validation criteria. When that is not performed, an unacceptable level of false-positive and false-negative test results is virtually assured."
TITLE:
Ocular manifestations and treatment of Lyme disease.
AUTHORS:
Karma A; Mikkila H
AUTHOR
AFFILIATION:
Department of Ophthalmology, Helsinki University Central Hospital, Finland.
SOURCE:
Curr Opin Ophthalmol 1996 Jun;7(3):7-12
"Patients with late ocular.[sic] Lyme disease may be seronegative by routine enzyme-linked immunosorbent assays, but immunoblot or detection of Borrelia DNA by polymerase chain reaction may help in diagnosing those cases."
TITLE:
Polymerase chain reaction detection of Lyme disease: correlation with clinical manifestations and serologic responses.
AUTHORS:
Mouritsen CL; Wittwer CT; Litwin CM; Yang L; Weis JJ; Martins TB; Jaskowski TD; Hill HR
AUTHOR
AFFILIATION:
Laboratory of Immunology and Infectious Diseases, Associated Regional and University Pathologists, Salt Lake City, UT 84108, USA.
SOURCE:
Am J Clin Pathol 1996 May;105(5):647-54
"Polymerase chain reaction analysis of serum and synovial fluid may be of significant diagnostic value in Lyme disease, especially in the absence of a serologic response in early, partially treated and seronegative chronic disease. This is the first study to report an association between PCR positivity and the absence of a serologic response to Lyme borreliosis."
TITLE:
Lymphoproliferative responses to Borrelia burgdorferi in the diagnosis of Lyme arthritis in children and adolescents.
AUTHORS:
Huppertz HI; Mosbauer S; Busch DH; Karch H
AUTHOR
AFFILIATION:
Universitatskinderklinik, Wurzburg, Germany.
SOURCE:
Eur J Pediatr 1996 Apr;155(4):297-302
"In patients with LA [Lyme arthritis] the test [lymphocyte proliferation assay] may turn positive after antibiotic therapy and remain positive for up to 19 months after the disappearance of arthritis. The test does not aid in prognosis or follow up. In one patient with seronegative LA specific lymphocyte proliferation and polymerase chain reaction for borrelial fla sequences in urine were positive."
TITLE:
Lymphoproliferative responses to Borrelia burgdorferi in circumscribed scleroderma.
AUTHORS:
Breier P; Klade H; Stanek G; Poitschek C; Kirnbauer R; Dorda W; Aberer E
AUTHOR
AFFILIATION:
Department of Dermatology, University of Vienna, Austria.
SOURCE:
Br J Dermatol 1996 Feb;134(2):285-91
"These findings show that the pattern of Bb-specific immune responses is more complex than previously thought, and underscore the importance of lymphocyte function assays in evaluating the diagnosis of potential Bb infection in seronegative patients."
TITLE:
Antibodies against whole sonicated Borrelia burgdorferi spirochetes, 41- kilodalton flagellin, and P39 protein in patients with PCR- or culture- proven late Lyme borreliosis.
AUTHORS:
Oksi J; Uksila J; Marjamaki M; Nikoskelainen J; Viljanen MK
AUTHOR
AFFILIATION:
Department of Medicine, Turku University Central Hospital, Finland.
SOURCE:
J Clin Microbiol 1995 Sep;33(9):2260-4
"These results show that antibodies to B. burgdorferi may be present in low levels or even absent in patients with culture- or PCR-proven late LB. Therefore, in addition to serological testing, the use of PCR and cultivation is recommended in the diagnosis of LB."
TITLE:
Current status of laboratory diagnosis for Lyme disease.
AUTHORS:
Magnarelli LA
AUTHOR
AFFILIATION:
Department of Entomology, Connecticut Agricultural Experiment Station, New Haven 06504, USA.
SOURCE:
Am J Med 1995 Apr 24;98(4A):10S-12S; discussion 12S-14S
"However, aside from being more expensive, culturing B. burgdorferi from human tissues and fluids gives us a low yield, while results of PCR analyses can be as misleading as those obtained by performing IFA staining methods or an ELISA if there are false-negative or false-positive reactions....Until highly sensitive and specific assays have been adequately standardized, diagnosis of Lyme disease should be based primarily on clinical and epidemiologic evidence."
TITLE:
Diagnosis and clinical characteristics of ocular Lyme borreliosis
[see comments]
AUTHORS:
Karma A; Seppala I; Mikkila H; Kaakkola S; Viljanen M; Tarkkanen A
AUTHOR
AFFILIATION:
Department of Ophthalmology, University of Helsinki, Finland.
SOURCE:
Am J Ophthalmol 1995 Feb;119(2):127-35
COMMENT:
Comment in: Am J Ophthalmol 1995 Aug;120(2):263-4
"Results of ELISA disclosed that five patients were seropositive, two patients showed borderline reactivity, and three patients were seronegative. Four of the five patients with borderline or negative
results by ELISA had a positive result by western blot analysis... CONCLUSIONS: Late-phase ocular Lyme borreliosis is probably underdiagnosed because of weak seropositivity or seronegativity in ELISA assays."
TITLE:
[Lymphocyte proliferation test in cutaneous manifestations of Lyme borreliosis]
AUTHORS:
Breier F; Klade H; Stanek G
AUTHOR
AFFILIATION:
Abteilung fur allgemeine Dermatologie, Universitatsklinik fur Dermatologie, Wien.
SOURCE:
Wien Med Wochenschr 1995;145(7-8):170-3
"Since patients with seronegative Lyme borreliosis have been described, lymphocyte proliferation tests may be used for detecting patients who only develop a cellular immunoreactivity against Bb organisms"
TITLE:
Acute childhood neuroborreliosis with a selective immune response to a low molecular weight protein expressed by Borrelia garinii.
AUTHORS:
Huppertz HI; Horneff G; Neudorf U; Karch H
AUTHOR
AFFILIATION:
Universitatskinderklinik, Wurzburg, Germany.
SOURCE:
Eur J Pediatr 1994 Dec;153(12):898-902
"In contrast serological tests using B. burgdorferi sensu stricto, associated with arthritis, or using VS461 strains (B. afzelii), associated with chronic skin disease, were false-negative. ...Results of serological tests for Lyme borreliosis may depend on the infecting strain and on the choice of the strain used as antigen source for diagnostic tests. The attending physician should interpret serological test results with care and rely on astute clinical judgement."
TITLE:
Cytologically proven seronegative Lyme choroiditis and vitritis.
AUTHORS:
Schubert HD; Greenebaum E; Neu HC
AUTHOR
AFFILIATION:
Edward S. Harkness Eye Institute, New York, New York.
SOURCE:
Retina 1994;14(1):39-42
"Intravitreal spirochetes consistent with Borrelia burgdorferi were found in this seronegative patient. CONCLUSION: Vitreous specimens of patients with choroiditis and vitritis of unknown cause should be examined cytologically, particularly when serologic results do not corroborate the clinical findings of Lyme disease."
TITLE:
Electron microscopy and the polymerase chain reaction of spirochetes from the blood of patients with Lyme disease.
AUTHORS:
Hulinska D; Krausova M; Janovska D; Rohacova H; Hancil J; Mailer H
AUTHOR
AFFILIATION:
Department of Electron Microscopy, National Institute of Public Health, Prague, Czech Republic.
SOURCE:
Cent Eur J Public Health 1993 Dec;1(2):81-5
"Results of studies using direct antigen detection suggest that seronegative Lyme borreliosis is not rare and support the hypothesis that Borrelia antigens can persist in humans."
TITLE:
Recurrent erythema migrans despite extended antibiotic treatment with minocycline in a patient with persisting Borrelia burgdorferi infection.
AUTHORS:
Liegner KB; Shapiro JR; Ramsay D; Halperin AJ; Hogrefe W; Kong L
AUTHOR
AFFILIATION:
Department of Medicine, Northern Westchester Hospital Center,
Mount Kisco, NY.
SOURCE:
J Am Acad Dermatol 1993 Feb;28(2 Pt 2):312-4
"The patient was seronegative by Lyme enzyme-linked immunosorbent assay but showed suspicious bands on Western blot. Findings of a Warthin-Starry stain of a skin biopsy specimen of the eruption revealed a Borrelia-compatible structure."
TITLE:
Performance of 45 laboratories participating in a proficiency testing program for Lyme disease serology.
AUTHORS:
Bakken LL; Case KL; Callister SM; Bourdeau NJ; Schell RF
AUTHOR
AFFILIATION:
Wisconsin State Laboratory of Hygiene, University of Wisconsin,
Madison 53706.
SOURCE:
JAMA 1992 Aug 19;268(7):891-5
"RESULTS--Interlaboratory and intralaboratory performances were highly variable. Approximately 4% to 21% of laboratories failed to identify correctly positive serum samples with titers of 512 or more using polyvalent serum or immunoglobulin G conjugates. With lower levels of anti-Borrelia burgdorferi antibody in the serum sample, approximately 55% of participating laboratories did not identify a case-defined serum. ...CONCLUSIONS--Our results indicate that there is an urgent need for standardization of current testing methodologies. Until a national commitment is made, serological testing for Lyme disease will be of questionable value for the diagnosis of the disease."
TITLE:
Lyme disease associated with fibromyalgia.
AUTHORS:
Dinerman H; Steere AC
AUTHOR
AFFILIATION:
Tufts University School of Medicine, Boston, Massachusetts.
SOURCE:
Ann Intern Med 1992 Aug 15;117(4):281-5
"...and the three seronegative patients had positive cellular immune
responses to borrelial antigens."
TITLE:
Molecular detection of persistent Borrelia burgdorferi in a man with dermatomyositis.
AUTHORS:
Fraser DD; Kong LI; Miller FW
AUTHOR
AFFILIATION:
National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland.
SOURCE:
Clin Exp Rheumatol 1992 Jul-Aug;10(4):387-90
"In addition, this case emphasizes the potential clinical utility of PCR technology in evaluating the persistent sero-negative Lyme disease which may occur in immunocompromised individuals."
TITLE:
Isolation of Borrelia burgdorferi from a Lyme seronegative patient in northern Italy: expression of OspB immunodominant proteins on the isolated strain.
AUTHORS:
Cinco M; Trevisan G; Agolzer A
AUTHOR
AFFILIATION:
Istituto di Microbiologia, Universita degli Studi di Trieste, Italy.
SOURCE:
Microbiologica 1992 Apr;15(2):95-8
"This paper describes the antigenic characteristics of a strain of Borrelia burgdorferi isolated from a patient seronegative for Lyme borreliosis, in the early stage of the illness. The strain was not recognized by a late serum sample from the patient; the isolate reacted in immunoblotting with some of the monoclonal antibodies directed against the immunodominant antigens of Borrelia burgdorferi."
TITLE:
PCR detection of Borrelia burgdorferi DNA in cerebrospinal fluid of Lyme neuroborreliosis patients [see comments]
AUTHORS:
Keller TL; Halperin JJ; Whitman M
AUTHOR
AFFILIATION:
Division of Cell and Molecular Biology, Dana Farber Cancer Institute, Boston, MA.
SOURCE:
Neurology 1992 Jan;42(1):32-42
COMMENT:
Comment in: Neurology 1992 Sep;42(9):1849-50
"PCR detected B burgdorferi OspA DNA in CSF of (1) 10 of 11 patients with Lyme encephalopathy, (2) 28 of 37 patients with inflammatory CNS disease, (3) seven of seven seronegative patients with Lyme-compatible disorders, and (4) zero of 23 patient controls."
TITLE:
Amplification of Borrelia burgdorferi DNA in skin biopsies from patients with Lyme disease.
AUTHORS:
Melchers W; Meis J; Rosa P; Claas E; Nohlmans L; Koopman R;
Horrevorts A; Galama J
AUTHOR
AFFILIATION:
Department of Medical Microbiology, University Hospital Nijmegen, The Netherlands.
SOURCE:
J Clin Microbiol 1991 Nov;29(11):2401-6
"The spirochete could be isolated from the biopsy sample, from a patient with erythema chronicum migrans who tested negative, which suggests a false-negative polymerase chain reaction result probably on account of the low number of spirochetes present in the lesion."
TITLE:
[Serodiagnosis of Lyme disease by ELISA using Borrelia burgdorferi flagellum antigen]
AUTHORS:
Kawabata M; Kubo N; Arashima Y; Yoshida M; Kawano K
AUTHOR
AFFILIATION:
Department of Clinical Pathology, Nihon University School of Medicine, Tokyo.
SOURCE:
Rinsho Byori 1991 Aug;39(8):891-4
"In three cases of patients with erythema migrans preceded by tick-bite, and treated with antibiotics, seronegative results were observed by a immunoperoxidase (IP) test. Since two of them showed the positive level of IgM antibody by the flagellum ELISA, this method seems to be more sensitive and useful than the IP test for serodiagnosis of the Lyme disease."
TITLE:
Detection of Borrelia burgdorferi in patients with Lyme disease by the polymerase chain reaction.
AUTHORS:
Guy EC; Stanek G
AUTHOR
AFFILIATION:
Public Health Laboratory, General Hospital, Southampton.
SOURCE:
J Clin Pathol 1991 Jul;44(7):610-1
"Two out of five patients with erythema migrans, the characteristic primary skin lesion associated with early Lyme disease, were positive by the PCR. This method could form the basis of a useful routine laboratory
test in those cases of early Lyme disease where conventional serological testing commonly yields equivocal or false negative results."
TITLE:
T cell proliferation induced by Borrelia burgdorferi in patients with
Lyme borreliosis. Autologous serum required for optimum stimulation.
AUTHORS:
Krause A; Brade V; Schoerner C; Solbach W; Kalden JR; Burmester GR
AUTHOR
AFFILIATION:
Department of Medicine III, University of Erlangen-Nuernberg, Germany.
SOURCE:
Arthritis Rheum 1991 Apr;34(4):393-402
"These data indicate that lymphocyte proliferation assays may provide an important tool for the diagnosis of Lyme borreliosis, most notably in patients with arthritides and in those who are seronegative."
TITLE:
Seronegative Lyme disease. Dissociation of specific T- and B-lymphocyte responses to Borrelia burgdorferi [see comments]
AUTHORS:
Dattwyler RJ; Volkman DJ; Luft BJ; Halperin JJ; Thomas J; Golightly MG
AUTHOR
AFFILIATION:
Department of Medicine, State University of New York, School of Medicine, Stony Brook 11794-8161.
SOURCE:
N Engl J Med 1988 Dec 1;319(22):1441-6
COMMENT:
Comment in: N Engl J Med 1989 May 11;320(19):1279-80
"We conclude that the presence of chronic Lyme disease cannot be excluded by the absence of antibodies against B. burgdorferi and that a specific T-cell blastogenic response to B. burgdorferi is evidence of infection in seronegative patients with clinical indications of chronic Lyme disease."
TITLE:
Serological diagnosis of erythema migrans disease and related disorders.
AUTHORS:
Wilske B; Schierz G; Preac-Mursic V; Weber K; Pfister HW; Einhaupl K
SOURCE:
Infection 1984 Sep-Oct;12(5):331-7
"In the IgM test, false negative reactions caused by high-titered specific IgG antibodies or false positive reactions caused by rheumatoid factor occur. This can be avoided by testing the IgM fraction (19S-IgM-test) or using sera previously treated with anti-IgG serum."
TITLE:
Transmission risk of Borrelia burgdorferi sensu lato from Ixodes ricinus ticks to humans in southwest Germany.
AUTHORS:
Maiwald M; Oehme R; March O; Petney TN; Kimmig P; Naser K; Zappe HA; Hassler D; von Knebel Doeberitz M
AUTHOR
AFFILIATION:
Hygiene-Institut der Universitat, Abt. Hygiene und Med. Mikrobiologie, Heidelberg, Germany. un69mm@genius.embnet.dkfz-heidelberg.de
SOURCE:
Epidemiol Infect 1998 Aug;121(1):103-8
"Transmission occurred to 16 (26.7%) of 60 patients who were initially seronegative and could be followed up after the bite of an infected tick."
TITLE:
TITLE:
[The clinico-epidemiological and laboratory characteristics of the early period of Lyme borreliosis in Kirov Province]
AUTHORS:
Bondarenko AL; Abbasova SV; Tikhomolova EG; Tikhomolova EP; Savinykh MV; Komarova LB
SOURCE:
Med Parazitol (Mosk) 1997 Oct-Dec;(4):18-21
"The serological tests were false-negative in early infection or just after initiation of treatment."
TITLE:
Lyme borreliosis--problems of serological diagnosis.
AUTHORS:
Hofmann H
AUTHOR
AFFILIATION:
Klinik fur Dermatologie und Allergologie am Biederstein, Technische Universitat Munchen, Germany.
SOURCE:
Infection 1996 Nov-Dec;24(6):470-2
"In erythema migrans of less than 4 weeks' duration, 50% of patients are seronegative even with newly designed ELISAs."
TITLE:
The molecular diagnosis of cutaneous infection.
AUTHORS:
Jaworsky C
AUTHOR
AFFILIATION:
Department of Dermatology, University of Pennsylvania,
Philadelphia 19026.
SOURCE:
J Cutan Pathol 1993 Dec;20(6):508-12
"In early seronegative cases, spirochetes can be detected in primary inoculation lesions by darkfield microscopy or in tissue sections with appropriate stains. Conversely, detection of Borrelia burgdorferi is currently fraught with difficulties. Tissue sections stained for these spirochetes are difficult to interpret, and serologic studies have shown widely variable results. The polymerase chain reaction has already been applied to the study of Borrelia infection with encouraging early results."
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TITLE:
Primary and secondary erythema migrans in central Wisconsin.
AUTHORS:
Melski JW; Reed KD; Mitchell PD; Barth GD
AUTHOR
AFFILIATION:
Department of Dermatology, Marshfield Clinic, WI 54449.
SOURCE:
Arch Dermatol 1993 Jun;129(6):709-16
"CONCLUSIONS--Borrelia burgdorferi can be reliably cultured from skin biopsy specimens of secondary EM. Culture preparation aids definitive diagnosis of Lyme disease in patients with only primary EM who often lack constitutional symptoms, have nondiagnostic lesions, or are seronegative."
TITLE:
Lyme disease: testing and treatment. Who should be tested and treated for Lyme disease and how?
AUTHORS:
Sigal LH
AUTHOR
AFFILIATION:
Department of Medicine, University of Medicine and Dentistry of
New Jersey, Robert Wood Johnson Medical School, New Brunswick.
SOURCE:
Rheum Dis Clin North Am 1993 Feb;19(1):79-93
"On the other hand, a patient with ECM or other manifestations of LD may still be seronegative."
TITLE:
Lyme borreliosis in Bell's palsy. Long Island Neuroborreliosis
Collaborative Study Group [see comments]
AUTHORS:
Halperin JJ; Golightly M
AUTHOR
AFFILIATION:
Department of Neurology, State University of New York, Stony Brook.
SOURCE:
Neurology 1992 Jul;42(7):1268-70
COMMENT:
Comment in: Neurology 1993 Sep;43(9):1865-6
"Between July and September 1989, LB serologies were performed on all patients with new- onset Bell's palsy. Seven of 32 had serologic evidence of LB at onset. One, initially seronegative, was highly seropositive 5 weeks later."
TITLE:
Childhood Lyme borreliosis in Europe.
AUTHORS:
Huppertz HI
AUTHOR
AFFILIATION:
Children's Hospital, University of Wurzburg, Federal Republic of Germany.
SOURCE:
Eur J Pediatr 1990 Sep;149(12):814-21
"Tests may be false-negative early in the course of the disease or after early treatment."
TITLE:
[The presence of antibodies to Borrelia burgdorferi associated with immunologic complexes in sera of foresters]
AUTHORS:
Sobieszczanska BM; Nozka B; Milczarska J; Dobracka B; Dobracki W
AUTHOR
AFFILIATION:
Katedra i Zaklad Mikrobiologii Akademii Medycznej we Wroclawiu.
SOURCE:
Med Dosw Mikrobiol 1998;50(1-2):97-103
"In 24 (46.2%) seronegative sera after dissociation of immune complexes IgM antibodies to spirochaeta were found. The rest of the examined seronegative sera we failed to find IgM antibodies to Borrelia burgdorferi. The diagnostic assay, such as antibody analysis of immune components is useful in establishing of the diagnosis of borreliosis in seronegative cases and monitoring of disease activity. That method should be introduced for routine diagnosis of Lyme disease."
TITLE:
Detection of Borrelia burgdorferi-specific antigen in antibody-negative cerebrospinal fluid in neurologic Lyme disease.
AUTHORS:
Coyle PK; Schutzer SE; Deng Z; Krupp LB; Belman AL; Benach JL; Luft BJ
AUTHOR
AFFILIATION:
Department of Neurology, SUNY at Stony Brook, USA.
SOURCE:
Neurology 1995 Nov;45(11):2010-5
"...and three (20%) with characteristic syndromes for Lyme disease were seronegative, but had complexed antibody to B burgdorferi."
TITLE:
Seronegative chronic relapsing neuroborreliosis [see comments]
AUTHORS:
Lawrence C; Lipton RB; Lowy FD; Coyle PK
AUTHOR
AFFILIATION:
Department of Medicine, Albert Einstein College of Medicine,
New York, N.Y., USA.
SOURCE:
Eur Neurol 1995;35(2):113-7
COMMENT:
Comment in: Eur Neurol 1996;36(6):394-5
"Although the patient never had detectable free antibodies to B. burgdorferi in serum or spinal fluid, the CSF was positive on multiple occasions for complexed anti-B. burgdorferi antibodies, B. burgdorferi nucleic acids and free antigen."
TITLE:
Sequestration of antibody to Borrelia burgdorferi in immune complexes in seronegative Lyme disease.
AUTHORS:
Schutzer SE; Coyle PK; Belman AL; Golightly MG; Drulle J
AUTHOR
AFFILIATION:
Department of Medicine, University of Medicine and Dentistry-New Jersey Medical School, Newark 07103.
SOURCE:
Lancet 1990 Feb 10;335(8685):312-5
"To find out whether apparent seronegativity in patients strongly suspected of having Lyme disease can be due to sequestration of antibodies in immune complexes, such complexes were isolated and tested for antibody to Borrelia burgdorferi. In a blinded analysis the antibody was detected in all 10 seronegative Lyme disease patients with erythema chronicum migrans (ECM), in none of 19 patients with other diseases, and in 4 of 12 seronegative patients who probably had Lyme disease but had no ECM."
TITLE:
[Laboratory diagnosis of Lyme borreliosis]
AUTHORS:
Hoogkamp-Korstanje JA
AUTHOR
AFFILIATION:
Afd. Medische Microbiologie, Academisch Ziekenhuis St. Radboud, Nijmegen.
SOURCE:
Ned Tijdschr Geneeskd 1997 Nov 29;141(48):2339-42
"Cross reactions, antigenic variations and differences in antigenic expression in American and European strains may cause false-negative and false-positive results with the current tests. Moreover, previous use of antibiotics can interfere with the production of specific antibodies, and the effect of therapy is not correlated with height and behaviour of antibody titres. Additional investigation with immunoblot techniques, demonstrating specific antibody patterns may be valuable. An interesting alternative, not yet fully developed, is detection of specific antigens in tissues."
TITLE:
Articular involvement in European patients with Lyme disease. A report of 32 Italian patients [see comments]
AUTHORS:
Bianchi G; Rovetta G; Monteforte P; Fumarola D; Trevisan G; Crovato F; Cimmino MA
AUTHOR
AFFILIATION:
Cattedra di Reumatologia, Universita di Genova, Italy.
SOURCE:
Br J Rheumatol 1990 Jun;29(3):178-80
COMMENT:
Comment in: Br J Rheumatol 1991 Feb;30(1):71
"In addition, interpreting serological tests for antibodies against B. burgdorferi and the real prevalence of arthritis in LD is complicated by the possible existence of seronegative LD and by the effect of early antibiotic treatment."
TITLE:
Survival of Borrelia burgdorferi in antibiotically treated patients
with Lyme borreliosis.
AUTHORS:
Preac-Mursic V; Weber K; Pfister HW; Wilske B; Gross B; Baumann A;
Prokop J
AUTHOR
AFFILIATION:
Neurologische Klinik Grosshadern, Munchen, FR Germany.
SOURCE:
Infection 1989 Nov-Dec;17(6):355-9
"Antibiotic therapy may abrogate the antibody response to the infection as shown in our patients. B. burgdorferi may persist as shown by positive culture in MKP-medium; patients may have subclinical or clinical disease without diagnostic antibody titers to B. burgdorferi. We conclude that early stage of the disease as well as chronic Lyme disease with persistence of B. burgdorferi after antibiotic therapy cannot be excluded when the serum is negative for antibodies against B. burgdorferi."
TITLE:
Pathogenesis of neuroborreliosis--lessons from a monkey model.
AUTHORS:
Pachner AR; Schaefer H; Amemiya K; Cadavid D; Zhang WF; Reddy K;
O'Neill T
AUTHOR
AFFILIATION:
Department of Neurology, Georgetown University Hospital,
Washington, D.C., USA.
SOURCE:
Wien Klin Wochenschr 1998 Dec 23;110(24):870-3
"The presence of specific anti-B. burgdorferi antibody in the CSF is the most widely used assay for Lyme neuroborreliosis. In the immunocompetent NHPs [nonhumane (sic) primates] in our study it was a very successful assay for detection of CNS invasion. However, it is frequently false-negative, especially early in the course of the infection, or if there is transient immunosuppression. Transient suppression of the anti-B. burgdorferi immune response in the human could occur in instances of co-infection, i.e. simultaneous transmission via the tick of another pathogen other than B. burgdorferi. Thus, mild immunosuppression as
accomplished in our NHPs with corticosteroids was designed to mimic conditions in the human host which allow B. burgdorferi in the natural state to gain a firm foothold in the central nervous system in the 10-15% of B. burgdorferi-infected patients who develop clinically symptomatic nervous system disease. ...In immunocompromised NHPs, intrathecal antibody production was delayed, and this helpful diagnostic assay was false-negative; diagnosis required more labor-intensive assays such as PCR, culture, an... [abstract truncates here]."
Last updated on 6 January 2000 by
Art Doherty
Lompoc, California
doherty@utech.net
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