DETECTION OF BORRELIA-BURGDORFERI DNA BY POLYMERASE CHAIN-REACTION INCEREBROSPINAL-FLUID IN LYME NEUROBORRELIOSIS

A polymerase chain reaction (PCR) assay that detects Borrelia burgdorf eri DNA in cerebrospinal fluid (CSF) was evaluated as a diagnostic tes t for acute or chronic Lyme neuroborreliosis, In one laboratory, 102 s amples were tested blindly, and 40 samples were retested in a second l aboratory, In the first laboratory, B. burgdorferi DNA was detected in CSF samples in 6 (38%) of 16 patients with acute neuroborreliosis, 11 (25%) of 44 with chronic neuroborreliosis, and none of 42 samples fro m patients with other illnesses, There was a significant correlation b etween PCR results and the duration of previous intravenous antibiotic therapy. The overall frequency of positive results was similar in the second laboratory, but concordance between the laboratories and among primer-probe sets was limited because many samples were positive with only one primer-probe set, Thus, PCR testing can sometimes detect B. burgdorferi DNA in CSF in patients with acute or chronic neuroborrelio sis, but with current methods, the sensitivity of the test is limited.