Clinical, diagnostic and immunological characteristics of patients with possible neuroborreliosis without intrathecal Ig-synthesis against Borrelia antigen in the cerebrospinal fluid

The diagnosis of neuroborreliosis is not always straightforward. Intrathecal immunoglobulin (Ig) synthesis against Borrelia antigen may not be detected, at least early in the disease course. Also other neurological and infectious diagnoses have to be considered. We have studied patients with clinical possible neuroborreliosis without intrathecal Ig synthesis against Borrelia antigen in the cerebrospinal fluid (CSF) (n=17). Diagnosis was based on typical clinical history and at least one of the following findings; mononuclear leucocytosis in the CSF (n=4); typical erythema migrans >5 cm in diameter in relation to debut of symptoms (n=8); prompt clinical response to antibiotic teratment (n=14). Also other possible diagnoses had to be excluded. Seventeen patients first investigated because of suspected neuroborreliosis but later confirmed with other diagnoses were used as controls. All patients had a lumbar puncture. Borrelia specific IFN-γ and IL-4 secretion was investigated in peripheral blood (PBL) and CSF with an ELISPOT assay. Polymerase chain reaction (PCR) was used to reveal any Borrelia antigen in the CSF. Six of 17 patients with possible neuroborreliosis showed high IFN-g secretion in peripheral blood, otherwise we found no statistically significant differences between the groups. PCR did not reveal any Borrelia antigen in CSF. The diagnosis and treatment of possible but not confirmed neuroborreliosis is a clinical challenge. The clinical response to treatment may be the best option in these cases.

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Polymerase Chain Reaction Analysis for Specific HTLV-1 Sequences from Cerebrospinal Fluid and Peripheral Blood Cells in Sardinian Multiple Sclerosis Patients

European Neurology ◽

10.1159/000116821 ◽

1992 ◽

Vol 32 (4) ◽

pp. 195-198 ◽

Cited By ~ 1

Author(s):

Maria Giovanna Marrosu ◽

Anna Paola Mazzoleni ◽

Silvana Galantuomo ◽

Antonello Melis ◽

Francesco Muntoni ◽

...

Keyword(s):

Multiple Sclerosis ◽

Polymerase Chain Reaction ◽

Cerebrospinal Fluid ◽

Peripheral Blood ◽

Blood Cells ◽

Polymerase Chain Reaction Analysis ◽

Peripheral Blood Cells ◽

Chain Reaction ◽

Polymerase Chain ◽

Multiple Sclerosis Patients

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7. Polymerase chain reaction analysis for specific HTLV-1 sequences from cerebrospinal fluid and peripheral blood cells in multiple sclerosis patients from Sardinia

Journal of Neuroimmunology ◽

10.1016/0165-5728(91)90141-s ◽

1991 ◽

Vol 34 (2-3) ◽

pp. 244

Author(s):

Maria Giovanna Marrosu ◽

Anna Paola Mazzoleni ◽

Silvana Galantuomo ◽

Antonello Melis ◽

Francesco Muntoni ◽

...

Keyword(s):

Multiple Sclerosis ◽

Polymerase Chain Reaction ◽

Cerebrospinal Fluid ◽

Peripheral Blood ◽

Blood Cells ◽

Polymerase Chain Reaction Analysis ◽

Peripheral Blood Cells ◽

Chain Reaction ◽

Polymerase Chain ◽

Multiple Sclerosis Patients

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A Reappraisal of Chlamydial and Non-Chlamydial Acute Non-Gonococcal Urethritis

International Journal of STD & AIDS ◽

10.1177/095646249200300307 ◽

1992 ◽

Vol 3 (3) ◽

pp. 191-195 ◽

Cited By ~ 9

Author(s):

P E Hay ◽

B J Thomas ◽

C Gilchrist ◽

H M Palmer ◽

C B Gilroy ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Clinical History ◽

Response To Treatment ◽

Direct Immunofluorescence ◽

Chain Reaction ◽

Gonococcal Urethritis ◽

First Pass ◽

Polymerase Chain ◽

The Difference ◽

Intensive Investigation

A cohort of 112 men presenting with acute non-gonococcal urethritis (NGU) was investigated for the presence of Chlamydia trachomatis. Men with 3 or more episodes of NGU in the preceding 12 months, or who had received treatment for NGU in the preceding 3 months were excluded. C. trachomatis was sought by examination of urethral smears by direct immunofluorescence, and by examination of the centrifuged deposit from a first pass urine (FPU) sample by direct immunofluorescence, IDEIA, and the polymerase chain reaction. Urethral samples from 48 men were positive for CT, and the FPU samples from an additional 7 men were positive by at least 2 assays. With such intensive investigation it is likely that those men identified as chlamydia-negative were genuinely free from the infection. The clinical history and response to treatment of those men who were chlamydia-positive were compared with those of the chlamydia-negative men. They differed in that a larger proportion of the chlamydia-positive men reported having had intercourse with more than one partner in the previous 3 months, and having had fewer previous episodes of NGU. Moreover, in contrast to some previous studies, after one week of treatment with doxycycline, a larger proportion (65%) of the chlamydia-negative men than the chlamydia-positive men (40%) was cured, although the difference was not sustained following later treatment.

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Borrelia lusitaniae Infection Mimicking Headache, Neurologic Deficits, and Cerebrospinal Fluid Lymphocytosis

Journal of Child Neurology ◽

10.1177/0883073819858263 ◽

2019 ◽

Vol 34 (12) ◽

pp. 748-750

Author(s):

José Pedro Vieira ◽

Maria João Brito ◽

Isabel Lopes de Carvalho

Keyword(s):

Polymerase Chain Reaction ◽

Cerebrospinal Fluid ◽

International Headache Society ◽

Clinical History ◽

Chain Reaction ◽

Headache Syndrome ◽

Neurologic Deficits ◽

Borrelia Lusitaniae ◽

Polymerase Chain

Headache with neurologic deficits and cerebrospinal fluid lymphocytosis (HaNDL) is a rare headache syndrome included in the Classification of Headache of the International Headache Society as a “headache attributed to non-infectious inflammatory intracranial disease.” We report one 15-year-old patient with clinical history and cerebrospinal fluid findings compatible with the diagnosis of HaNDL in whom Borrelia lusitaniae was identified in cerebrospinal fluid by polymerase chain reaction.

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Semi-quantitative analysis of cytokine gene expression in blood and cerebrospinal fluid cells by reverse transcriptase polymerase chain reaction

Research in Experimental Medicine ◽

10.1007/bf02576770 ◽

1995 ◽

Vol 195 (1) ◽

pp. 17-29 ◽

Cited By ~ 34

Author(s):

P. Rieckmann ◽

M. Albrecht ◽

H. Ehrenreich ◽

T. Weber ◽

U. Michel

Keyword(s):

Gene Expression ◽

Polymerase Chain Reaction ◽

Cerebrospinal Fluid ◽

Quantitative Analysis ◽

Reverse Transcriptase ◽

Cytokine Gene Expression ◽

Cytokine Gene ◽

Chain Reaction ◽

Cerebrospinal Fluid Cells ◽

Polymerase Chain

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West Nile Virus Chorioretinitis in the Presence of Negative Cerebrospinal Fluid Polymerase Chain Reaction Results

Journal of VitreoRetinal Diseases ◽

10.1177/2474126420979254 ◽

2021 ◽

pp. 247412642097925

Author(s):

Kareem Moussa ◽

Karen W. Jeng-Miller ◽

Leo A. Kim ◽

Dean Eliott

Keyword(s):

Cerebrospinal Fluid ◽

West Nile Virus ◽

Cross Sectional Study ◽

Nucleic Acid Amplification ◽

Sectional Study ◽

Chain Reaction ◽

West Nile ◽

Cross Sectional ◽

Positive Serum ◽

Polymerase Chain

Purpose: This work aims to evaluate the utility of nucleic acid amplification testing (NAAT) and serology in confirming West Nile Virus (WNV) infection in patients with suspected WNV chorioretinitis. Methods: A retrospective cross-sectional study was conducted of a cluster of patients who presented to the Retina Service of Massachusetts Eye and Ear between September and October 2018. Results: Three patients were identified with classic WNV chorioretinitis lesions with negative cerebrospinal fluid NAAT and positive serum serology findings. The diagnosis of WNV chorioretinitis was made based on the appearance of the fundus lesions and the presence of characteristic findings on fluorescein angiography as previously described in the literature. Conclusions: This report highlights 3 unique cases of WNV chorioretinitis in which NAAT of cerebrospinal fluid failed to identify WNV as the inciting agent. These cases stress the importance of serum serologic testing in diagnosing WNV infection.

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