Abstract
Erythema migrans, the most common manifestation of Lyme disease, has been associated with highly variable rates of seropositivity for antibodies to Borrelia burgdorferi. Differences in the sensitivities of serologic assays for the detection of these antibodies, however, may not be the only or even the primary explanation for this observation. We investigated the impacts of four clinical variables on seropositivity--the duration of erythema migrans, the presence of single versus multiple skin lesions, and the gender and age of the patient. In this analysis, three different serologic tests were performed on acute-phase sera from 175 untreated patients with culture-confirmed erythema migrans: the C6 single-peptide enzyme-linked immunosorbent assay (ELISA), a commercially available ELISA in which a whole-cell sonicate of B. burgdorferi was the antigen, and a two-tier procedure. Irrespective of the serologic test performed, the results showed that seropositivity rates increased with the duration of the erythema migrans for patients with single lesions (P < 0.001) but not for those with multiple skin lesions. The variability in seropositivity rates was greatest for the two-tier testing strategy, with a >6-fold-higher rate of seroposi...Continue Reading
References
Sep 27, 1995·JAMA : the Journal of the American Medical Association
Aug 1, 1994·Journal of Clinical Microbiology·P D MitchellJ W Melski
Dec 1, 1993·Journal of Clinical Microbiology·M E Aguero-RosenfeldG P Wormser
Jan 1, 1996·Journal of Clinical Microbiology·M E Aguero-RosenfeldG P Wormser
Aug 7, 1999·The Journal of Infectious Diseases·G P WormserI Schwartz
Nov 24, 1999·Journal of Clinical Microbiology·F T LiangM T Philipp
Nov 24, 1999·Journal of Clinical Microbiology·M B LawrenzS J Norris
Nov 14, 2001·Infection and Immunity·A VazA C Steere
Apr 16, 2003·The Journal of Infectious Diseases·Rendi Murphree BaconBarbara J B Johnson
Jul 16, 2005·Clinical Microbiology Reviews·Maria E Aguero-RosenfeldGary P Wormser
Oct 10, 2006·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Gary P WormserRobert B Nadelman
Dec 13, 2006·Wiener klinische Wochenschrift·Emel CetinGerold Stanek
Aug 30, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Gary P WormserIra Schwartz
Citations
Jan 29, 2011·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·C W AngT Herremans
May 17, 2012·PloS One·Mark W EshooJohn N Aucott
May 3, 2014·The New England Journal of Medicine·Eugene D Shapiro
Oct 25, 2013·Expert Review of Molecular Diagnostics·Mark W EshooDavid J Ecker
Sep 28, 2010·Gender Medicine·Alison SchwarzwalderJohn N Aucott
Nov 26, 2015·Clinics in Laboratory Medicine·Martin E Schriefer
Feb 29, 2016·Journal of Autoimmunity·Jameson T CrowleyAllen C Steere
Jul 22, 2015·Emerging Infectious Diseases·Anna GrankvistChristine Wennerås
May 23, 2015·Infectious Disease Clinics of North America·Adriana R Marques
Oct 16, 2012·Diagnostic Microbiology and Infectious Disease·Gary P WormserJ Stephen Dumler
Jun 14, 2014·Clinical Rheumatology·Alison W RebmanJohn N Aucott
Mar 1, 2012·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·V SeriburiG P Wormser
May 28, 2016·Diagnostic Microbiology and Infectious Disease·Erica WeitznerGary P Wormser
Apr 6, 2018·PLoS Pathogens·Bharti BhatiaPatricia A Rosa
Jun 15, 2018·Journal of Clinical Microbiology·Adriana R Marques
Dec 2, 2011·FASEB Journal : Official Publication of the Federation of American Societies for Experimental Biology·Raphael B Stricker, Lorraine Johnson
May 28, 2020·BMJ : British Medical Journal·Bart Jan KullbergJoppe W Hovius
Mar 18, 2020·BMJ Case Reports·Michael S LundinDebra A Spicehandler
Apr 25, 2019·BMC Public Health·Allison DeLongHarriet Kotsoris
Aug 4, 2018·Frontiers in Immunology·Lisa K BlumWilliam H Robinson
Mar 23, 2017·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·John A BrandaAllen C Steere
Dec 1, 2020·PloS One·Srirupa DasPaul N Fiedler
Oct 23, 2020·Journal of Clinical Microbiology·Michael R MoselJohn N Aucott
Jan 9, 2021·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Paul M LantosLawrence S Zemel
Jan 29, 2021·Clinical Microbiology Reviews·John A Branda, Allen C Steere
Sep 10, 2021·PloS One·Richard Porwancher, Lisa Landsberg