title: A Lyme borreliosis diagnosis probability score - no relation with antibiotic treatment response.
abstract: OBJECTIVE
  (1) To describe epidemiological and clinical data of patients that present with the suspicion of Lyme borreliosis (LB); (2) to evaluate a previous published score that classifies patients on the probability of having LB, following-up patients' clinical outcome after antibiotherapy.
  
  
  METHODS
  Inclusion criteria: patients with clinical manifestations compatible with LB and Borrelia (B.) burgdorferi positive serology, hospitalized in a Romanian hospital between January 2011 and October 2012.
  
  
  METHODS
  erythema migrans (EM) or suspicion of Lyme neuroborreliosis (LNB) with lumbar puncture performed for diagnosis. A questionnaire was completed for each patient regarding associated diseases, tick bites or EM history and clinical signs/symptoms at admission, end of treatment and 3 months later. Two-tier testing (TTT) used an ELISA followed by a Western Blot kit. The patients were classified in groups, using the LB probability score and were evaluated in a multidisciplinary team. Antibiotherapy followed guidelines' recommendations.
  
  
  RESULTS
  Sixty-four patients were included, presenting diverse associated comorbidities. Fifty-seven patients presented positive TTT, seven presenting either ELISA or Western Blot test positive. No differences in outcome were found between the groups of patients classified as very probable, probable and little probable LB. Instead, a better post-treatment outcome was described in patients with positive TTT.
  
  
  CONCLUSIONS
  The patients investigated for the suspicion of LB present diverse clinical manifestations and comorbidities that complicate differential diagnosis. The LB diagnosis probability score used in our patients did not correlate with the antibiotic treatment response, suggesting that the probability score does not bring any benefit in diagnosis.
authors.affiliation: a Department of Infectious Diseases , "Iuliu Hatieganu" University of Medicine and Pharmacy , Cluj Napoca , Romania.|b Clinical Hospital of Infectious Diseases , Cluj Napoca , Romania.
authors.forename: Violeta T
authors.initials: VT
authors.lastname: Briciu
authors.affiliation: b Clinical Hospital of Infectious Diseases , Cluj Napoca , Romania.
authors.forename: Mirela
authors.initials: M
authors.lastname: Flonta
authors.affiliation: c Department of Medical Informatics and Biostatistics , Iuliu Hatieganu" University of Medicine and Pharmacy , Cluj Napoca , Romania.
authors.forename: Daniel
authors.initials: D
authors.lastname: Leucuţa
authors.affiliation: a Department of Infectious Diseases , "Iuliu Hatieganu" University of Medicine and Pharmacy , Cluj Napoca , Romania.
authors.forename: Dumitru
authors.initials: D
authors.lastname: Cârstina
authors.affiliation: a Department of Infectious Diseases , "Iuliu Hatieganu" University of Medicine and Pharmacy , Cluj Napoca , Romania.|b Clinical Hospital of Infectious Diseases , Cluj Napoca , Romania.
authors.forename: Doina F
authors.initials: DF
authors.lastname: Ţăţulescu
authors.affiliation: a Department of Infectious Diseases , "Iuliu Hatieganu" University of Medicine and Pharmacy , Cluj Napoca , Romania.|b Clinical Hospital of Infectious Diseases , Cluj Napoca , Romania.
authors.forename: Mihaela
authors.initials: M
authors.lastname: Lupşe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015153:Blotting, Western; D002648:Child; D003661:Decision Support Techniques; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008193:Lyme Disease / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012383:Romania / Q000453:epidemiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Lyme borreliosis; differential diagnosis; probability score