Evaluation of the polymerase chain reaction for the detection of Borrelia burgdorferi in cerebrospinal fluid of children with acute peripheral facial palsy.
Neuroborreliosis occasionally represents a diagnostic problem, especially in the early stage of the infection. The polymerase chain reaction (PCR) offers an attractive alternative to antibody testing. The aim of our study was to investigate the diagnostic potential of PCR in comparison to antibody tests in CSF of children with facial palsy. In contrast to other manifestations of neuroborreliosis, facial palsy is a well-defined clinical entity in which CSF findings allow an early distinction according to aetiology. The study included 17 children with neuroborreliosis, defined by the detection of specific IgM antibodies in CSF, and 20 children with facial palsy of unknown cause. Primers used for the nested PCR were generated from conserved sequences of the OspA-gene. Most of the cases in both subgroups have been examined within a few days after the onset of the paresis. Only in 2 out of 17 cases with neuroborreliosis could specific DNA be amplified. The PCR gave negative results in all cases of the control group.


CONCLUSIONS
The IgM capture ELISA is superior to PCR to support the clinical diagnosis of neuroborreliosis.
Christen
H J
HJ
Department of Medical Microbiology, University of Göttingen, Germany.
Eiffert
H
H
Ohlenbusch
A
A
Hanefeld
F
F
D000208:Acute Disease; D000293:Adolescent; D000907:Antibodies, Bacterial / Q000134:cerebrospinal fluid; D001483:Base Sequence; D001899:Borrelia Infections / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D015748:Borrelia burgdorferi Group / Q000302:isolation & purification*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005158:Facial Paralysis / Q000134:cerebrospinal fluid / Q000382:microbiology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid; D007075:Immunoglobulin M / Q000134:cerebrospinal fluid; D008193:Lyme Disease / Q000134:cerebrospinal fluid / Q000382:microbiology; D008297:Male; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction / Q000379:methods*
D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D007075:Immunoglobulin M