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Title:Proportion of confirmed Lyme neuroborreliosis cases among adult patients with suspected early European Lyme neuroborreliosis
Authors:ID Ogrinc, Katarina (Author)
ID Bogovič, Petra (Author)
ID Rojko, Tereza (Author)
ID Maraspin-Čarman, Vera (Author)
ID Ružić-Sabljić, Eva (Author)
ID Kastrin, Andrej (Author)
ID Strle, Klemen (Author)
ID Wormser, Gary P. (Author)
ID Strle, Franc (Author)
Files:.pdf PDF - Presentation file, download (1,07 MB)
MD5: 23E6F9953F186877A5DBA6E13F78578A
 
URL URL - Source URL, visit https://link.springer.com/article/10.1007/s15010-024-02461-0
 
Language:English
Typology:1.01 - Original Scientific Article
Organization:Logo UKC LJ - Ljubljana University Medical Centre
Abstract:Purpose To determine the frequency of confirmed Lyme neuroborreliosis (LNB) cases in adult patients with three different clinical presentations consistent with early LNB. Methods Data were obtained through routine health care at the UMC Ljubljana, Slovenia from 2005 to 2022, using clinical pathways. The patients were classified into three groups: (i) radicular pain of new onset (N=332); or (ii) involvement of cranial nerve(s) but without radicular pain (N=997); or (iii) erythema migrans (EM) skin lesion(s) in conjunction with symptoms suggestive of nervous system involvement but without either cranial nerve palsy or radicular pain (N=240). The diagnosis of LNB considered the following variables: the presence of: (1) neurologic symptoms consistent with LNB (with no other obvious explanation); (2) cerebrospinal fluid (CSF) pleocytosis (>5×▫$10^$▫ leukocytes/L); and (3) demonstration of intrathecal synthesis of borrelial antibodies, and/or cultivation of borrelia from CSF, and/or the presence of EM. Patients fulfilling only the first two criteria were interpreted as having possible LNB, while those who satisfied all three criteria were regarded as having confirmed LNB. Results Of 1569 adult patients, 348 (22.2%) had confirmed LNB and 70 (4.5%) others had possible LNB. The proportion of confirmed LNB cases was the highest for patients with radicular pain (217/332, 65.4%), followed by the group with EM and neurologic symptoms (47/240, 19.6%), and those with cranial neuritis (84/997, 8.4%). Conclusion Only 22% of patients evaluated had confirmed LNB. The proportion of confirmed LNB cases correlated with clinical presentation and was highest among patients with recent onset of radicular pain.
Keywords:Lyme borreliosis, Lyme neuroborreliosis, criteria, cerebrospinal fluid, Bannwarth syndrome, cranial neuritis, borrelial meningitis, intrathecal borrelial antibody synthesis, Borrelia culture
Publication status:Published
Publication version:Version of Record
Year of publishing:2025
Number of pages:str. 1403–1412
Numbering:Vol. 53, issue 4
PID:20.500.12556/DiRROS-24540 New window
UDC:616.9
ISSN on article:0300-8126
DOI:10.1007/s15010-024-02461-0 New window
COBISS.SI-ID:237288707 New window
Publication date in DiRROS:04.12.2025
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Downloads:13
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Record is a part of a journal

Title:Infection
Shortened title:Infection
Publisher:MMV-Medizin-Verlag
ISSN:0300-8126
COBISS.SI-ID:6312711 New window

Document is financed by a project

Funder:Other - Other funder or multiple funders
Funding programme:Univerzitetni klinični center Ljubljana
Project number:20220127
Name:Značilnosti borelijskih vrst, ki povzročajo lymsko nevroboreliozo

Funder:Other - Other funder or multiple funders
Project number:R21AI144916
Name:Defining Host Genetic Factors in Adverse Clinical Outcomes in Lyme Disease

Funder:Other - Other funder or multiple funders
Project number:K01AR062098
Name:Defining Microbial and Host Factors in Innate Immune Responses in Lyme Arthritis

Funder:ARIS - Slovenian Research and Innovation Agency
Project number:P3-0296-2022
Name:Bolezni in povzročitelji, ki jih v Sloveniji prenašajo členonožci

Funder:ARIS - Slovenian Research and Innovation Agency
Project number:J3-1744-2019
Name:Poglobljena analiza vplivov dejavnikov povzročitelja in gostitelja pri akutni in kronični lymski boreliozi

Funder:ARIS - Slovenian Research and Innovation Agency
Project number:J3-8195-2017
Name:Dejavniki povzročitelja in gostitelja, ki vplivajo na klinične znake, težo in izid lymske borelioze

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License:CC BY-NC-ND 4.0, Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
Link:http://creativecommons.org/licenses/by-nc-nd/4.0/
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