title: Comparison of detection of Borrelia burgdorferi DNA and anti-Borrelia burgdorferi antibodies in patients with erythema migrans in north-eastern Poland.
abstract: BACKGROUND
  Diagnostic methods in erythema migrans are still not standardized.
  
  
  OBJECTIVE
  To evaluate the frequency of Borrelia burgdorferi s.l. DNA presence in patients with erythema migrans (EM); to assess the polymerase chain reaction (PCR) procedure for detecting B. burgdorferi s.l. DNA in patients with the skin form of Lyme borreliosis; and to compare the results of the PCR-based method with the traditional ELISA method.
  
  
  METHODS
  Skin biopsy and blood samples from 93 patients with EM were examined for B. burgdorferi s.l. DNA detection (PCR). Seventy-one of these patients were examined for the presence of anti-B. burgdorferi s.l. antibodies (ELISA).
  
  
  RESULTS
  Borrelia burgdorferi s.l. DNA was detected in 48% of the skin biopsy specimens and in 2% of blood samples. Only 1 patient was PCR positive in both blood and skin samples. Seventy percent of patients whose PCR results were positive were bitten by a tick less than 14 days before. IgM anti-B. burgdorferi s.l - specific antibodies were present in the serum of 35% of patients and IgG antibodies - in 30% of patients. Seventeen percent were positive in both IgM and IgG.
  
  
  CONCLUSIONS
  Polymerase chain reaction of skin biopsy specimens seems to be currently the most sensitive and specific test for the diagnosis of patients with EM, especially in patients with a short duration of the disease (< 14 days) but still its effectiveness is much lower than expected. Polymerase chain reaction of blood samples cannot be recommended at the present time for the routine diagnostic of patients with EM.
authors.affiliation: Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland. Head of Department: Prof. Slawomir Pancewicz MD, PhD.
authors.forename: Anna
authors.initials: A
authors.lastname: Moniuszko
authors.affiliation: Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland. Head of Department: Prof. Slawomir Pancewicz MD, PhD.
authors.forename: Justyna
authors.initials: J
authors.lastname: Dunaj
authors.affiliation: Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland. Head of Department: Prof. Slawomir Pancewicz MD, PhD.
authors.forename: Joanna
authors.initials: J
authors.lastname: Zajkowska
authors.affiliation: Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland. Head of Department: Prof. Slawomir Pancewicz MD, PhD.
authors.forename: Piotr
authors.initials: P
authors.lastname: Czupryna
authors.affiliation: Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland. Head of Department: Prof. Slawomir Pancewicz MD, PhD.
authors.forename: Renata
authors.initials: R
authors.lastname: Świerzbińska
authors.affiliation: Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland. Head of Department: Prof. Slawomir Pancewicz MD, PhD.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Guziejko
authors.affiliation: Department of Dermatology and Venereology, Medical University of Bialystok, Bialystok, Poland. Head of Department: Prof. Iwona Flisiak MD, PhD.
authors.forename: Piotr
authors.initials: P
authors.lastname: Aleksiejczuk
authors.affiliation: The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Roslin, Scotland, UK. Head of Department: Prof. John Fazakerley.
authors.forename: Gerald
authors.initials: G
authors.lastname: Barry
authors.affiliation: Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland. Head of Department: Prof. Slawomir Pancewicz MD, PhD.
authors.forename: Maciej
authors.initials: M
authors.lastname: Kondrusik
authors.affiliation: Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland. Head of Department: Prof. Slawomir Pancewicz MD, PhD.
authors.forename: Sławomir
authors.initials: S
authors.lastname: Pancewicz
keywords: Borrelia burgdorferi; ELISA; erythema migrans; polymerase chain reaction
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