Detection of Borrelia burgdorferi in cerebrospinal fluid by the polymerase chain reaction

Methodological Aspects

“…Correlation of PCR results with clinical improvement could also be shown in patients with late disease, e.g., patients with neuroborreliosis (59,75,84,88,93); patients with ACA, morphea, and lichen sclerosus et atrophicus (1,4,114,155,179); patients with LA (19,22,52,78,123); and a patient with osteomyelitis (126).…”

“…Not surprisingly, procedures involving simpler methods have been developed; these include simple boiling of the specimen (88), centrifugation and boiling (31), alkali lysis (111), adsorption to coated or uncoated silica in the presence of chaotropic salts (7,21,51,68,105), boiling and concentration by centrifugation and ultrafiltration (128), and boiling in the presence of a cation exchanger (Chelex 100; Bio-Rad, Richmond, Calif.) (93). Although the mechanism by which Chelex improves the DNA extraction, is not known, it is thought to aid in stabilizing the DNA double helix (182).…”

“…Furthermore, a PCR that uses urine as DNA source must be checked for reactions with common urinary tract pathogens (155,156). If CSF is used as the specimen, viral and bacterial pathogens known to be involved in central nervous system (CNS) infections (7,88,101) should be tested for cross-reactivity.…”

“…Studies with specimens from humans have shown negative PCR results shortly after treatment of patients with neuroborreliosis (84,88,93). Two patients have been reported with PCR reactivity in CSF 14 days after onset of therapy (88).…”

“…Studies with specimens from humans have shown negative PCR results shortly after treatment of patients with neuroborreliosis (84,88,93). Two patients have been reported with PCR reactivity in CSF 14 days after onset of therapy (88). In patients with EM, treatment is generally effective (51,118), although treatment failures with minocycline have been detected by PCR (99).…”