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Cytologic features of cerebrospinal fluid in Lyme disease
Abstract:
The cytomorphologic findings in the cerebrospinal fluid (CSF) of four patients with lymphocytic meningoradiculitis (Lyme disease) related to a tick bite (due in at least two cases to Borrelia burgdorferi) are reported. In all cases, the May-Grünwald-Giemsa-stained centrifuge preparations of the CSF showed a cellular pattern consisting of a lymphocytic pleocytosis composed mainly of immunoblasts and plasma cells associated with numerous foamy macrophages. Direct immunofluorescence studies in one case showed the polyclonal pattern of the immunoblasts and the plasma cells. These CSF findings can be considered as suggestive of the spirochetal origin of a lymphocytic meningitis following a tick bite.
Insights
Cerebrospinal fluid analysis revealed specific cell patterns in patients with Lyme disease, suggesting a spirochetal origin. These findings aid in diagnosing lymphocytic meningitis following tick bites.
Area of Science:
- Neuroscience
- Infectious Diseases
- Cytopathology
Background:
- Lymphocytic meningoradiculitis, commonly known as Lyme disease, is an infection caused by Borrelia burgdorferi.
- Tick bites are the primary vector for transmitting Lyme disease to humans.
- Cerebrospinal fluid (CSF) analysis is crucial for diagnosing neurological manifestations of Lyme disease.
Purpose of the Study:
- To report and analyze the cytomorphologic findings in the CSF of patients with Lyme disease.
- To identify characteristic cellular patterns in CSF that suggest a spirochetal origin.
Main Methods:
- Analysis of CSF samples from four patients diagnosed with lymphocytic meningoradiculitis.
- May-Grünwald-Giemsa staining of CSF centrifuge preparations.
- Direct immunofluorescence studies in one case.
Main Results:
- CSF revealed a lymphocytic pleocytosis with a predominance of immunoblasts and plasma cells.
- Numerous foamy macrophages were consistently observed in the CSF.
- Immunofluorescence showed a polyclonal pattern in immunoblasts and plasma cells.
Conclusions:
- The observed CSF cytomorphology, including specific cell types and foamy macrophages, is suggestive of Lyme disease.
- These findings support the diagnosis of spirochetal meningitis in patients with a history of tick bites.