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Are There Undiagnosed TBE-, Herpes- or Enteroviral Infections among Children Being Evaluated for Lyme Neuroborreliosis?
Center for Clinical Research, Falun, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Infectious Diseases.
Smittskyddsinstutet .
Östergötlands Läns Landsting, Center for Health and Developmental Care, Department of Infection Control.
2014 (English)In: Open Journal of Clinical Diagnostics, ISSN 2162-5816, E-ISSN 2162-5824, Vol. 4, no 3, 123-129 p.Article in journal (Refereed) Published
Abstract [en]

Lyme neuroborreliosis (LNB) in children is a challenging diagnosis based on clinical manifestations and laboratory findings. The aim of this study was to investigate whether herpes simplex virus (HSV) 1 or 2, varicella zoster virus (VZV), enterovirus or tick-borne encephalitis virus (TBEV) could be identified in cerebrospinal fluid (CSF) or serum from children being evaluated for LNB, in order to elucidate whether such infectious diseases may be missed by the clinician. Methods: Ninety-nine pediatric patients (n = 99) were retrospectively included from a previous study on LNB in southeast of Sweden. They had been diagnosed as “Possible LNB” or “Not determined” due to negative Borrelia antibody index in CSF. Routine polymerase chain reaction (PCR) methods were used for detection of herpes viral RNA or enteroviral DNA in CSF. An ELISA assay was used for detection of anti-TBEV antibodies (IgM and IgG) in serum. Results: One patient showed elevated anti-TBEV IgM and IgG antibodies in serum, indicating a current TBE infection. No positive PCR reactions for HSV 1 or 2, VZV or enterovirus were detected in CSF from any of the patients. In conclusion, our results suggest that undiagnosed herpes- or enteroviral infections are unlikely to explain CNS symptoms in children being evaluated for LNB, whereas missed TBE infections may occur. TBEV serology should be included when evaluating children for LNB in TBE endemic areas.

Place, publisher, year, edition, pages
Scientific Research Publishing, 2014. Vol. 4, no 3, 123-129 p.
Keyword [en]
Enterovirus, Herpes Simplex Virus, Lyme Neuroborreliosis, Varicella Zoster Virus, Tick-Borne Encephalitis
National Category
Infectious Medicine
URN: urn:nbn:se:liu:diva-110996DOI: 10.4236/ojcd.2014.43020OAI: diva2:751875
Available from: 2014-10-02 Created: 2014-10-02 Last updated: 2015-08-12

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Forsberg, Pia
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Division of Microbiology and Molecular MedicineFaculty of Health SciencesDepartment of Infectious DiseasesDepartment of Infection Control
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