Neurosyphilis oder Neuroborreliose

Abstract

We present laboratory data from 22 patients suspected of having neurosyphilis. In two cases the suspicion could not be confirmed, and in 20 cases neurosyphilis was detected. The sera from 17 patients were also assayed for Borrelia-specific antibodies. Suspicious immunoglobulin G antibody indices were detected in nine cases and a suspicious immunoglobulin M antibody index in one. In six of these, stored CSF/serum pairs were available to specify the antibodies by immunoblotting. This allowed for the identification of one patient apparently infected by both Borrelia spp. and Treponema pallidum. In all cases of newly suspected neurosyphilis, we recommend considering neuroborreliosis at the same time.

Diagnostic performance of cerebrospinal fluid chemokine CXCL13 and antibodies to the C6-peptide in Lyme neuroborreliosis

“…The CSF-Serum CXCL13 ratios are higher in LNB compared to NS patients primarily due to higher serum CXCL13 levels in NS (22-23). Although the two diseases can mimic each other clinically (24), LNB is generally much more common than NS in areas where LB is prevalent. For instance, the incidence of LB has been reported to be 69 per 100.000 inhabitants and year in the south of Sweden (1), compared with an incidence of 1.9 for syphilis, according to the Swedish Institute for Infectious Disease Control.…”

Severe course of Lyme neuroborreliosis in an HIV-1 positive patient; case report and review of the literature

“…Also, false positive serologic findings are described in patients with neurological infections with other spirochetes such as Treponema pallidum [7]. Present patients' clinical presentation was compatible with a localised cerebral infection with B. burgdorferi , confirmed by the positive serology, intrathecal specific anti- Borrelia antibody production and a positive real-time PCR for B. burgdorferi OspA on the CSF.…”

Molecular identification of tick-borne pathogens in asymptomatic individuals with human immunodeficiency virus type 1 (HIV-1) infection: a retrospective study

“…There is a well-known cross-reactivity between the Borrelia and Treponema spirochetes and false positive serologic findings are described in patients with neurological infections with other spirochetes such as T. pallidum [ 12 , 20 ]. In our case, the results of a serological test were indeterminate.…”

“…Currently, thanks to the improvement of the effectiveness of treatment, the majority of HIV positive patients has a significant improvement in the immune system function and consequently the positive predictive value (PPV) risk for serological tests is significantly lower. Moreover, false positive serologic findings are described in patients with neurological infections with other spirochetes such as Treponema pallidum [ 20 ].…”