Early Lyme disease with spirochetemia - diagnosed by DNA sequencing

A sensitive and analytically specific nucleic acid amplification test (NAAT) is valuable in confirming the diagnosis of early Lyme disease at the stage of spirochetemia.FindingsVenous blood drawn from patients with clinical presentations of Lyme disease was tested for the standard 2-tier screen and Western Blot serology assay for Lyme disease, and also by a nested polymerase chain reaction (PCR) for B. burgdorferi sensu lato 16S ribosomal DNA.

The PCR amplicon was sequenced for B. burgdorferi genomic DNA validation.

A total of 130 patients visiting emergency room (ER) or Walk-in clinic (WALKIN), and 333 patients referred through the private physicians'offices were studied. While 5.4% of the ER/WALKIN patients showed DNA evidence of spirochetemia, none (0%) of the patients referred from private physicians'offices were DNA-positive.

In contrast, while 8.4% of the patients referred from private physicians'offices were positive for the 2-tier Lyme serology assay, only 1.5% of the ER/ WALKIN patients were positive for this antibody test. The 2-tier serology assay missed 85.7% of the cases of early Lyme disease with spirochetemia.

The latter diagnosis was confirmed by DNA sequencing.

Conclusion: Nested PCR followed by automated DNA sequencing is a valuable supplement to the standard 2-tier antibody assay in the diagnosis of early Lyme disease with spirochetemia. The best time to test for Lyme spirochetemia is when the patients living in the Lyme disease endemic areas develop unexplained symptoms or clinical manifestations that are consistent with Lyme disease early in the course of their illness.

Author: Sin Hang LeeVeronica VigliottiJessica VigliottiWilliam JonesJessie WilliamsJay Walshon
Credits/Source: BMC Research Notes 2010, 3:273

Published on: 2010-11-01

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Comments Page 1 of 1

Lyme Witness

Posted 569 days ago

Since this is on the public web, maybe it could be translated into English for people actually suffering from Lyme? that would be useful. Thank you for your research. Other useful information on Lyme disease tests - Lyme disease research database.

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