Division of Medical Microbiology, Department of Pathology, The Johns Hopkins University School of Medicine, 720 Rutland Avenue, Ross 624, Baltimore, MD 21205.
Lyme disease is usually diagnosed and treated based on clinical manifestations. However, laboratory testing is useful for patients with confusing presentations and for validation of disease in clinical studies.
Although cultivation of Borrelia burgdorferi is definitive, prior investigations have shown that no single test is optimal for Lyme disease diagnosis.
We applied high-volume blood culture, skin biopsy culture, PCR, and serodiagnosis to a cohort of patients with suspected Lyme disease acquired in Maryland and southern Pennsylvania.
The study was performed to confirm the relative utility of culture and to identify laboratory testing algorithms that will supplement clinical diagnosis.
Overall, 30 of 86 patients (35%) were culture positive, whereas an additional 15 of 84 (18%) were seropositive only (51% total sero- and culture positive), and PCR on skin biopsy identified 4 additional patients who were neither culture nor seropositive.
Among 49 laboratory test-positive patients, the highest sensitivity (100%) for diagnosis was obtained when culture, skin PCR, and serologic tests were used, although serologic testing with skin PCR was almost as sensitive (92%).
Plasma PCR was infrequently positive and provided no additional diagnostic value.
Although culture is definitive and has a relatively high sensitivity, the results required a mean of 3.5 weeks to recovery.
The combination of acute-phase serology and skin PCR was 75% sensitive, offering a practical and relatively rapid alternative for confirming clinical impression.
The full battery of tests could be useful for patients with confusing clinical signs or for providing strong laboratory support for clinical studies of Lyme disease.
"There have been few randomized clinical trials of treatment, so optimal choice of antibiotic or optimal duration of treatment are not known."
"Other antibiotic choices include phenoxymethyl penicillin, tetracycline, cefuroxime axetil, erythromycin, or azithromycin, with the latter two considered to be second line choices."
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This should make your treatment options much better.
posted
Too bad this isn't a mandatory read for all neuro's and rhumey's, as these are usually the first docs most are sent to for help w/ the many and unusual symptoms we are dealing with.
It would save a lot suffering, $$$, time, and probably a life.
-------------------- Stella Marie Posts: 694 | From US | Registered: Apr 2005
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Beverly
Frequent Contributor (5K+ posts)
Member # 1271
posted
Yeah..Ditto Tincup!!! Who can argue with the experts.
Posts: 6638 | From Michigan | Registered: Jun 2001
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AliG
Frequent Contributor (1K+ posts)
Member # 9734
posted
Have I told you lately that you're beautiful?
This is EXCELLENT info!!!!!!
Thanks for posting it! Ali
-------------------- Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner. Posts: 4881 | From Middlesex County, NJ | Registered: Jul 2006
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posted
I have NEVER tested positive for anything except nerve damage. Yet, I have and do run low grade fever, subnormal body temp and occasioonily normal body temp...i'm not fine.......but I do well on the tests...I must study for them inmy sleep
-------------------- Lyme is like the flu. You can get it and recover, but you can always get it again. Posts: 607 | From (deer tick)Heaven! Angeles National Forest | Registered: Oct 2000
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