Potentially misleading Western blot results in Lyme disease diagnosis

2006 ◽  
Vol 63 (3) ◽  
pp. 142-144
Author(s):  
S. Mavin ◽  
R. Evans ◽  
K. Appleyard ◽  
A.W.L. Joss ◽  
D.O. Ho-Yen
Keyword(s):  
Lyme Disease ◽  
Western Blot ◽  
Disease Diagnosis

scholarly journals Quality Control Assessment of Canadian Laboratories Testing for Lyme Disease

1991 ◽  
Vol 2 (1) ◽  
pp. 41-45
Author(s):  
Harvey Artsob ◽  
Maxwell Garvie
Keyword(s):  
Public Health ◽  
Quality Control ◽  
Lyme Disease ◽  
Borrelia Burgdorferi ◽  
Western Blot ◽  
Etiological Agent ◽  
Immunofluorescent Assay ◽  
Satisfactory Performance ◽  
Endemic Areas ◽  
Negative Controls

In June 1990 a quality control assessment was undertaken of Canadian public health laboratories testing for antibodies toBorrelia burgdorferi, the etiological agent of Lyme disease. Twenty sera were distributed to nine laboratories, including 12 obtained from patients in Lyme endemic areas and presumed to be serological positives, and eight prescreened negative controls. Seventeen serological reports were submitted, comprising nine enzyme-linked immunosorbent assays (elisa), six immunofluorescent assays and two Western blot assessments. Antibodies were detected in 11 of the 12 sera which had been presumed to be positive. Assuming 11 positive sera had been submitted, the test sensitivities varied from 88.9 to 100% byelisa, and 54.5 to 90.1% by immunofluorescent assay. Specificities were 100% for all but oneelisaand one immunofluorescent assay assessment. The results indicate a satisfactory performance byelisabut a need for upgrading or replacement of some immunofluorescent assay tests.

scholarly journals 1204. The Effect of Coinfection with Babesiosis and Lyme Disease on Novel Biomarkers

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S623-S624
Author(s):  
Michael D Lum ◽  
Kelsey Reardon ◽  
Rachel Spector ◽  
Evan Garry ◽  
Aikaterini Papamanoli ◽  
...  
Keyword(s):  
Lyme Disease ◽  
White Blood Cells ◽  
Clinical Manifestations ◽  
Peripheral Blood Smear ◽  
Disease Diagnosis ◽  
University Hospital ◽  
Babesia Microti ◽  
Indirect Bilirubin ◽  
Cdc Guidelines ◽  
Novel Biomarkers

Abstract Background Current literature presents conflicting results regarding the clinical manifestations of coinfection with Babesia microti (Babesiosis) and Borrelia burgdorferi (Lyme disease). The aim of this study is to investigate the effect that coinfection with Babesiosis and Lyme Disease has on standard and novel biomarkers markers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and procalcitonin (Pc), which may assist in elucidating how these pathogens interact within human hosts. Methods Babesia cases were collected from Stony Brook University Hospital from 2012 to 2019. Cases of Babesia were included if parasites were detected by peripheral blood smear and confirmed by PCR. Lyme disease diagnosis criteria involved 2-tier testing per CDC guidelines. Cases were divided into three cohorts based on if they had CRP, ESR or Pc tested. Cohorts were divided into two groups: Babesiosis alone vs coinfection with Lyme Disease. Median values were analyzed for the following biomarkers across both groups: parasitemia, hemoglobin (Hgb), white blood cells (WBC), platelets, indirect bilirubin (IB), lactate dehydrogenase, ESR, CRP and Pc. Fisher Exact and Wilcoxon Rank sum tests were used and P values < 0.05 were considered statistically significant. Results ESR values trended higher in monoinfection compared to coinfection (50 vs 36 mm/hr, p=0.63). Within this cohort, the coinfection group had significantly lower platelet values compared to monoinfection (52 vs. 75.5 K/uL, p=0.04, Table 1). Within the CRP and Pc cohorts, monoinfection had higher trends of parasitemia compared to coinfection (CRP group: 1.6 vs 0.7%, p=0.14, Pc group: 1.4 vs 0.7% p=1.0, Table 2&3). Pc levels were similar in both groups (1.1 vs 1.2 ng/mL, p=1.0, Table 3). Table 1: Demographics and Biomarkers for Patients with Babesiosis Monoinfection vs. Coinfection with Babesiosis and Lyme Disease that had ESR Measured. Table 2: Demographics and Biomarkers for Patients with Babesiosis Monoinfection vs. Coinfection with Babesiosis and Lyme Disease that had CRP Measured. Table 3: Demographics and Biomarkers for Patients with Babesiosis Alone vs Coinfection with Babesiosis and Lyme Disease that had Procalcitonin Measured. Conclusion Coinfection had significantly lower platelets within the ESR cohort but not in other cohorts. While not statistically significant, monoinfection showed greater trends of ESR and parasitemia, which is consistent with previous studies that suggest that B. burgdorferi may mitigate the effects of B. microti infection. CRP and Pc levels were similar across both groups suggesting that the utility of using novel biomarkers to elucidate the interaction between B. burgdorferi and B. microti during simultaneous infection requires further study. Disclosures All Authors: No reported disclosures

scholarly journals Bull’s-Eye and Nontarget Skin Lesions of Lyme Disease: An Internet Survey of Identification of Erythema Migrans

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
John N. Aucott ◽  
Lauren A. Crowder ◽  
Victoria Yedlin ◽  
Kathleen B. Kortte
Keyword(s):  
Infectious Disease ◽  
Lyme Disease ◽  
Early Recognition ◽  
Erythema Migrans ◽  
Skin Lesions ◽  
Disease Diagnosis ◽  
Internet Survey ◽  
Appropriate Use ◽  
Bull's Eye ◽  
Use Of Medical Services

Introduction. Lyme disease is an emerging worldwide infectious disease with major foci of endemicity in North America and regions of temperate Eurasia. The erythema migrans rash associated with early infection is found in approximately 80% of patients and can have a range of appearances including the classic target bull’s-eye lesion and nontarget appearing lesions.Methods. A survey was designed to assess the ability of the general public to distinguish various appearances of erythema migrans from non-Lyme rashes. Participants were solicited from individuals who visited an educational website about Lyme disease.Results. Of 3,104 people who accessed a rash identification survey, 72.7% of participants correctly identified the classic target erythema migrans commonly associated with Lyme disease. A mean of 20.5% of participants was able to correctly identify the four nonclassic erythema migrans. 24.2% of participants incorrectly identified a tick bite reaction in the skin as erythema migrans.Conclusions. Participants were most familiar with the classic target erythema migrans of Lyme disease but were unlikely to correctly identify the nonclassic erythema migrans. These results identify an opportunity for educational intervention to improve early recognition of Lyme disease and to increase the patient’s appropriate use of medical services for early Lyme disease diagnosis.

scholarly journals Lyme disease and Bell’s palsy: an epidemiological study of diagnosis and risk in England

2017 ◽  
Vol 67 (658) ◽  
pp. e329-e335 ◽  
Author(s):  
Lilli Cooper ◽  
Michael Branagan-Harris ◽  
Richard Tuson ◽  
Charles Nduka
Keyword(s):  
Lyme Disease ◽  
Facial Palsy ◽  
International Classification Of Diseases ◽  
Disease Diagnosis ◽  
Bell’S Palsy ◽  
Bell's Palsy ◽  
Health And Social Care ◽  
Classification Of Diseases ◽  
Patients At Risk ◽  
High Index Of Suspicion

BackgroundLyme disease is caused by a tick-borne spirochaete of the Borrelia species. It is associated with facial palsy, is increasingly common in England, and may be misdiagnosed as Bell’s palsy.AimTo produce an accurate map of Lyme disease diagnosis in England and to identify patients at risk of developing associated facial nerve palsy, to enable prevention, early diagnosis, and effective treatment.Design and settingHospital episode statistics (HES) data in England from the Health and Social Care Information Centre were interrogated from April 2011 to March 2015 for International Classification of Diseases 10th revision (ICD-10) codes A69.2 (Lyme disease) and G51.0 (Bell’s palsy) in isolation, and as a combination.MethodPatients’ age, sex, postcode, month of diagnosis, and socioeconomic groups as defined according to the English Indices of Deprivation (2004) were also collected.ResultsLyme disease hospital diagnosis increased by 42% per year from 2011 to 2015 in England. Higher incidence areas, largely rural, were mapped. A trend towards socioeconomic privilege and the months of July to September was observed. Facial palsy in combination with Lyme disease is also increasing, particularly in younger patients, with a mean age of 41.7 years, compared with 59.6 years for Bell’s palsy and 45.9 years for Lyme disease (P = 0.05, analysis of variance [ANOVA]).ConclusionHealthcare practitioners should have a high index of suspicion for Lyme disease following travel in the areas shown, particularly in the summer months. The authors suggest that patients presenting with facial palsy should be tested for Lyme disease.

scholarly journals Borrelia burgdorferi and Borrelia miyamotoi seroprevalence in California blood donors

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243950
Author(s):  
Sharon I. Brummitt ◽  
Anne M. Kjemtrup ◽  
Danielle J. Harvey ◽  
Jeannine M. Petersen ◽  
Christopher Sexton ◽  
...  
Keyword(s):  
Lyme Disease ◽  
Borrelia Burgdorferi ◽  
Western Blot ◽  
Sierra Nevada ◽  
Blood Donors ◽  
Test System ◽  
Emerging Diseases ◽  
Borrelia Miyamotoi ◽  
Increased Risk ◽  
Significant Difference

The western blacklegged tick, Ixodes pacificus, an important vector in the western United States of two zoonotic spirochetes: Borrelia burgdorferi (also called Borreliella burgdorferi), causing Lyme disease, and Borrelia miyamotoi, causing a relapsing fever-type illness. Human cases of Lyme disease are well-documented in California, with increased risk in the north coastal areas and western slopes of the Sierra Nevada range. Despite the established presence of B. miyamotoi in the human-biting I. pacificus tick in California, clinical cases with this spirochete have not been well studied. To assess exposure to B. burgdorferi and B. miyamotoi in California, and to address the hypothesis that B. miyamotoi exposure in humans is similar in geographic range to B. burgdorferi, 1,700 blood donor sera from California were tested for antibodies to both pathogens. Sampling was from high endemic and low endemic counties for Lyme disease in California. All sera were screened using the C6 ELISA. All C6 positive and equivocal samples and nine randomly chosen C6 negative samples were further analyzed for B. burgdorferi antibody using IgG western blot and a modified two ELISA test system and for B. miyamotoi antibody using the GlpQ ELISA and B. miyamotoi whole cell sonicate western blot. Of the 1,700 samples tested in series, eight tested positive for antibodies to B. burgdorferi (0.47%, Exact 95% CI: 0.20, 0.93) and two tested positive for antibodies to B. miyamotoi (0.12%, Exact 95% CI: 0.01, 0.42). There was no statistically significant difference in seroprevalence for either pathogen between high and low Lyme disease endemic counties. Our results confirm a low frequency of Lyme disease and an even lower frequency of B. miyamotoi exposure among adult blood donors in California; however, our findings reinforce public health messaging that there is risk of infection by these emerging diseases in the state.

scholarly journals Multiple Erythema Lesions Obscured As Fungal Skin Infection

2014 ◽  
Vol 2 (3) ◽  
pp. 472-473
Author(s):  
Allma Koçinaj ◽  
Antigona Gërçari ◽  
Mybera Ferizi ◽  
Edlira Lashi ◽  
Lorela Gjunkshi ◽  
...  
Keyword(s):  
Lyme Disease ◽  
Antimicrobial Agents ◽  
Skin Infection ◽  
Erythema Migrans ◽  
Disease Diagnosis ◽  
Infected Tick ◽  
Skin Changes ◽  
Acrodermatitis Chronica Atrophicans ◽  
First Case ◽  
Laboratory Features

Erythema migrans is a ring like erythema, with a few centimeters in diameter. Usually it occur solitary, days to weeks after an infected tick bite. According to skin changes it can be manifested acutely such as erythema migrans in Lyme Borreliosis, borrelial lymphocytoma (subacute), or as a late Lyme disease with acrodermatitis chronica atrophicans. All stages of this disease can be treatable with antimicrobial agents. As a first case in our department with multiple lesions, we describe a 14-year-old female and review the patient’s clinical and laboratory features, the causes of the disease, diagnosis as well as treatment.

scholarly journals Incidence of Lyme disease in the United Kingdom and association with fatigue: a population-based, historical cohort study

2021 ◽  
Author(s):  
Florence Brellier ◽  
Mar Pujades-Rodriguez ◽  
Emma Powell ◽  
Kathleen Mudie ◽  
Eliana Mattos Lacerda ◽  
...  
Keyword(s):  
Cohort Study ◽  
Lyme Disease ◽  
Incidence Rate ◽  
Chronic Fatigue ◽  
Disease Diagnosis ◽  
Population Based ◽  
Incidence Rates ◽  
Historical Cohort ◽  
Historical Cohort Study ◽  
The Uk

Objectives To evaluate incidence rates of Lyme disease in the UK and to investigate a possible association with subsequent fatigue Design Population-based historical cohort study with a comparator cohort matched by age, sex, and general practice Setting Patients treated in UK general practices contributing to IQVIA Medical Research Data Participants 2,130 patients with a first diagnosis of Lyme disease between 2000 and 2018, and 8,510 randomly-sampled matched comparators, followed-up for a median time of 3 years and 8 months. Main outcome measures Time from Lyme disease diagnosis to consultation for any fatigue-related symptoms or diagnosis and for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Adjusted hazard ratios (HRs) were estimated from Cox models. Results Average incidence rate for Lyme disease across the UK was 5.18 per 100,000 py between 2000 and 2018, increasing from 2.55 in 2000 to 9.33 in 2018. In total 929 events of any types of fatigue were observed, i.e. an incidence rate of 307.90 per 10,000 py in the Lyme cohort (282 events) and 165.60 in the comparator cohort (647 events). Effect of Lyme disease on any subsequent fatigue varied by index season with highest adjusted HRs in autumn [3.14 (95%CI: 1.92 to 5.13)] and winter [2.23 (1.21 to 4.11)]. Incidence rates of ME/CFS were 11.16 per 10,000 py in Lyme patients (12 events) and 1.20 in comparators (5 events), corresponding to an adjusted HR of 16.95 (5.17 to 55.60). Effect on any types of fatigue and ME/CFS was attenuated 6 months after diagnosis but still clearly visible. Conclusions UK primary care records provided strong evidence that Lyme disease was associated with acute and chronic fatigue. Albeit weaker, these effects persisted beyond 6 months, suggesting that patients and healthcare providers should remain alert to fatigue symptoms months to years following Lyme disease diagnosis.

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