Diagnosis of lyme borreliosis in europe.
Level 5 - mechanism / opinion, no new human data
Narrative review and guideline summary without systematic search methodology or original data.
PubMed 14733674 · doi:10.1089/153036603322662200
What was done
This narrative review outlines diagnostic protocols and German Society of Hygiene and Microbiology guidelines for Lyme borreliosis in Europe, addressing regional species diversity (B. burgdorferi sensu stricto, B. afzelii, and B. garinii). It describes two-step serological testing (ELISA followed by immunoblot), recombinant antigen utility, and specific indications for culture and PCR.
What was found
Serum antibody detection rates reported across disease stages are 20–50% in stage I, 70–90% in stage II, and nearly 100% in stage III. Direct detection yields positive results in 50–70% of skin biopsies (culture or PCR), 50–70% of synovial tissue or fluid samples (PCR), and 10–30% of cerebrospinal fluid samples. The review recommends against urine PCR, body fluid antigen tests, and lymphocyte transformation tests.
Why it matters
The paper summarizes standard diagnostic pathways tailored to European Borrelia heterogeneity and identifies unvalidated diagnostic tests that should not be used in clinical practice.
Limits
The abstract describes a narrative review without systematic search criteria, study selection methods, sample sizes, or formal meta-analytic data pooling. Diagnostic yields are reported as broad ranges without confidence intervals.
Cited by
- supports The C6 ELISA test checks for three strains of Borrelia: Borrelia burgdorferi, Borrelia afzelii, and Borrelia garinii.