Interesting study --definitively diagnosing Lyme

Discussion in 'Fibromyalgia Main Forum' started by victoria, Nov 5, 2005.

  1. victoria

    victoria New Member

    I received this from the Lymeinfo group at yahoo, this is an interesting study:
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    Two-Year Evaluation of Bb tests

    Journal of Clinical Microbiology, October 2005, p. 5080-5084, Vol. 43, No. 10

    Two-Year Evaluation of Borrelia burgdorferi Culture and Supplemental Tests for Definitive Diagnosis of Lyme Disease

    Peggy Coulter,1 Clara Lema,1 Diane Flayhart,1 Amy S. Linhardt,1 John N. Aucott,2 Paul G. Auwaerter,2 and J. Stephen Dumler1*

    Division of Medical Microbiology, Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland,1 Divisions of General Internal Medicine and Infectious Diseases, The Johns Hopkins University School of Medicine, Baltimore, Maryland2

    Received 14 April 2005/ Returned for modification 22 April 2005/ Accepted 13 July 2005

    Lyme disease is usually diagnosed and treated based on clinical manifestations. However, laboratory testing is useful for patients with confusing presentations and for validation of disease in clinical studies.

    Although cultivation of Borrelia burgdorferi is definitive, prior investigations have shown that no single test is optimal for Lyme disease diagnosis.

    We applied high-volume blood culture, skin biopsy culture, PCR, and serodiagnosis to a cohort of patients with suspected Lyme disease acquired in Maryland and southern Pennsylvania.

    The study was performed to confirm the relative utility of culture and to identify laboratory testing algorithms that will supplement clinical diagnosis. Overall, 30 of 86 patients (35%) were culture positive, whereas an additional 15 of 84 (18%) were seropositive only (51% total sero- and culture positive), and PCR on skin biopsy identified 4 additional patients who were neither culture nor seropositive.

    Among 49 laboratory test-positive patients, the highest sensitivity (100%) for diagnosis was obtained when culture, skin PCR, and serologic tests were used, although serologic testing with skin PCR was almost as sensitive (92%).

    Plasma PCR was infrequently positive and provided no additional diagnostic value. Although culture is definitive and has a relatively high sensitivity, the results required a mean of 3.5 weeks to recovery. The combination of acute-phase serology and skin PCR was 75% sensitive, offering a practical and relatively rapid alternative for confirming clinical impression.

    The full battery of tests could be useful for patients with confusing clinical signs or for providing strong laboratory support for clinical studies of Lyme disease.

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  2. morningsonshine

    morningsonshine New Member

    I know this is important but don't quit get it all, so what's the best way to be tested?

    Besides, i think it got buried so,,

    Bump
  3. victoria

    victoria New Member

    My understanding is that one should be given more than one type of test...

    "Among 49 laboratory test-positive patients, the highest sensitivity (100%) for diagnosis was obtained when culture, skin PCR, and serologic tests were used, although serologic testing with skin PCR was almost as sensitive (92%)...

    ...The full battery of tests could be useful for patients with confusing clinical signs or for providing strong laboratory support for clinical studies of Lyme disease."