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Comment & Response
January 2015

Laboratory Testing for Lyme Neuroborreliosis—Reply

Author Affiliations
  • 1Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 2Department of Internal Medicine, Duke University School of Medicine, Durham, North Carolina
  • 3Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
JAMA Neurol. 2015;72(1):126. doi:10.1001/jamaneurol.2014.3555

In Reply We agree with Lautner and colleagues that, in addition to the ratio of Borrelia burgdorferi antibodies between cerebrospinal fluid (CSF) and serum, tests, such as CSF white blood cell count, can be useful in the assessment of neuroborreliosis. Indeed, CSF analysis is a pivotal tool in making a diagnosis of meningitis. However, whether liberal use of CSF testing to assess for possible neuroborreliosis among patients not suspected to have meningitis would be practiced (given barriers to obtaining samples) or aid in enhancing diagnosis is uncertain.

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