[Neuroborreliosis: diagnostic difficulties]

Area of Science:

• Neurology
• Infectious Diseases
• Medical Diagnostics

Background:

• Borreliosis, caused by Borrelia burgdorferi, presents as a multi-organ disease with distinct stages.
• Increasingly diagnosed cases in Poland are linked to improved diagnostic test availability.
• Neuroborreliosis, a significant manifestation, requires precise diagnostic approaches.

Observation:

• Five patients with confirmed neuroborreliosis were identified via blood and CSF analysis using the 3M IgG/IgM Fastlyme fluorimetric method.
• Three patients exhibited bilateral facial nerve palsy with cerebrospinal fluid (CSF) abnormalities, including lymphocytic pleocytosis and elevated protein.
• Diagnostic challenges arose in staging, particularly for patients with dermatological (Acrodermatitis atrophicans) and neurological (shoulder plexus lesion) findings, suggesting potential misclassification or complex disease progression.

Findings:

• The study highlights the utility of the 3M IgG/IgM Fastlyme method in confirming neuroborreliosis.
• Complex presentations, including concurrent dermatological and neurological symptoms, complicate accurate disease staging.
• Delayed diagnosis or advanced disease stages may impact treatment efficacy, as observed in one patient.

Implications:

• Accurate and timely diagnosis of neuroborreliosis is essential for effective patient management.
• Standardized diagnostic criteria and staging protocols are needed to address complex clinical presentations.
• Further research into the correlation between disease stage, diagnostic timing, and treatment outcomes in Borrelia burgdorferi infections is warranted.