Detection ofBorrelia burgdorferiin Cerebrospinal Fluid of Patients with Lyme Borreliosis

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Abstract
Lyme borreliosis is a systemic disorder caused by Borrelia burgdorferi, a tick-borne spirochete. The infection frequently causes neurologic problems, but the causative agent has rarely been isolated from cerebrospinal fluid,1 , 2 because the organism is difficult to culture. The diagnosis has usually been based on immunologic methods (an indirect immunofluorescence assay or an enzyme immunoassay), but they lack sensitivity during the early stage of clinical involvement of the nervous system. Moreover, cross-reactions can occur in patients with syphilis, leptospirosis, or rheumatic diseases.3 , 4 DNA amplification by Tag polymerase5 (the polymerase chain reaction) may therefore be useful in the detection of B. burgdorferi in biologic samples. B. burgdorferi has been detected by amplification of DNA from Ixodes dammini,6 in blood and urine from infected dogs,7 and in urine from patients,8 although not from human cerebrospinal fluid.