CSF findings in Lyme meningitis

The results of cerebrospinal fluid examination in 59 cases of meningitis caused by Borrelia burgdorferi were analysed and compared with 73 non-Lyme meningitis cases. There was no statistically significant difference in the median cell count of 160 x 10(6)/l in the Lyme meningitis patients and the 150 x 10(6)/l in the non-Lyme cases. The protein level was elevated in both patients groups to 0.9 g/l and 0.8 g/l, respectively. The glucose level of 2.9 mmol/l (1.0-6.1) was, however, significantly (P = 0.005) lower in Lyme meningitis than the 3.3 mmol/l (1.6-5.4) in the non-Lyme cases. The most important observation of the study was the finding of a combination of pleocytosis, elevated protein (greater than 0.6 g/l) and low glucose levels (less than 2.1 mmol/l) (considered to be pathognostic for tuberculous meningitis) in six of 59 cases of Lyme meningitis.