Related Experiment Video
Updated: Aug 14, 2026
Feeding of Ticks on Animals for Transmission and Xenodiagnosis in Lyme Disease Research
Published on: August 31, 2013
Correlation of seroreactivity with response to antibiotics in pediatric Lyme borreliosis
P T Fawcett1, C D Rosé, K M Gibney
1Department of Clinical Science, Alfred I. duPont Institute, Wilmington, Delaware 19899, USA.
Insights
Accurate Lyme borreliosis diagnosis in children relies on serologic tests and erythema migrans (EM). Specific serologic tests can rule out Lyme disease in children with chronic symptoms, preventing unnecessary antibiotic use.
Area of Science:
- Pediatric infectious diseases
- Immunology
- Clinical microbiology
Background:
- Lyme borreliosis is a tick-borne illness caused by Borrelia burgdorferi.
- Accurate diagnosis in children is crucial for effective treatment and management.
- Distinguishing Lyme borreliosis from other conditions with similar symptoms can be challenging.
Purpose of the Study:
- To evaluate the correlation between serologic reactivity, clinical symptoms, and antibiotic treatment response in pediatric Lyme borreliosis.
- To determine the utility of highly specific serologic tests in ruling out Lyme borreliosis in children presenting with chronic symptoms.
Main Methods:
- Analysis of a pediatric cohort from a prospective study on Lyme borreliosis in an endemic area.
- Serologic testing using enzyme-linked immunosorbent assay (ELISA) and Western blotting.
- Clinical evaluation of antibiotic treatment response by a specialized pediatric Lyme clinic.
Main Results:
- Positive serologic test results and the presence of erythema migrans (EM) correlated with a favorable response to antibiotics.
- Seronegative pediatric patients without EM, presenting with chronic fatigue, arthralgia, or myalgia, did not respond to antibiotic treatment.
- Highly specific serologic tests demonstrated reliability in excluding Lyme borreliosis in children with chronic, non-EM symptoms.
Conclusions:
- Serologic testing is a valuable tool for diagnosing Lyme borreliosis in children, particularly when combined with clinical assessment.
- The absence of EM and negative serology in children with chronic symptoms suggests alternative diagnoses, guiding against unnecessary antibiotic therapy.
- Accurate diagnostic strategies, including specific serologic tests, are essential to prevent over-treatment and manage pediatric Lyme borreliosis effectively.
Abstract:
Response to treatment with antibiotics was compared with serologic reactivity and clinical symptoms in a pediatric population with presumptive diagnoses of Lyme borreliosis. The population analyzed for this study consisted of a subset of a larger Lyme clinic population being monitored as part of a prospective study on pediatric Lyme borreliosis. All patients resided in an area in which Ixodes scapularis and Borrelia burgdorferi are considered endemic. Serum from patients was tested by enzyme-linked immunosorbent assay and Western blotting. Response to antibiotics was evaluated by members of a pediatric Lyme clinic. Results showed that positive serologic test results correlate with a favorable response to antibiotics, as does the presence of erythema migrans (EM), regardless of serologic status. Seronegative patients without EM had chronic fatigue and arthralgia and/or myalgia as primary symptoms and did not respond to antibiotics, even when multiple courses of treatment were given. These results indicate that serologic tests designed to have high specificity can reliably rule out Lyme borreliosis in patients with chronic symptoms, thus preventing unnecessary treatment with antibiotics.
Related Concept Videos
00:42Cross-reactivity
01:26Rocky Mountain Spotted Fever