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Table 3 Clinical data on patients with detected Rickettsia DNA in CSF

From: Evidence of rickettsiae in Danish patients tested for Lyme neuroborreliosis: a retrospective study of archival samples

  Case 1 Case 2 Case 3 Case 4 Case 5 Case 6 Case 7 Case 8
Co-morbidity Asthma
Esophageal hernia
None None Colitis ulcerosa None None Spinal stenosis None
Symptoms - Bilateral peripheral facial palsy
- Radiculitis
- Unilateral peripheral facial palsy
- Headache
- Unilateral peripheral facial palsy
- Lower back pain
- Radiculitis
- Radiculitis
- Erythema migrans
- Myalgia
- Radiculitis
- Severe headache
- Pain in neck and shoulder girdle
- Fever
- Photophobia
- Transient hemiparesis - Sensorimotor polyneuropathy - Fever
- Headache
- Pain in neck and shoulder girdle
- Rash
Clinical diagnosis LNB LNB LNB LNB LNB Transient cerebral attack Enteroviral meningitis (PCR-verified)
SFG Rickettsia IFA NEG NEG NEG NEG NEG NEG NEG NEG
Intrathecal Borrelia-specific antibody synthesis (index ≥ 0.3) YES YES YES YES YES NO NO NO
CRP 5.3 <  1 <  1 6.7 <  1 1 2 130
CSF-leukocytes 34 100 863 192 300 2 1 133
CSF-protein 1.01 0.42 1.95 0.61 1.36 0.36 0.56 0.52
CSF-glucose 3.7 3.6 1.8 2.9 2.9 3.7 3.0
RT-PCR Ct value (CSF) 41 40 39.5 42 39.6 39 43.5 43.5
RT-PCR (sera) NEG NEG NEG NEG NEG NEG NEG NEG
Antibiotic treatment IV ceftriaxone + IV acyclovir IV ceftriaxone IV ceftriaxone IV ceftriaxone IV ceftriaxone IV ceftriaxone + IV acyclovir
Follow-up Asymptomatic 1 month post treatment Asymptomatic 1 month post treatment Clinical follow-up data missing. Well-being at hospital discharge. Responds to treatment. Slight headache and fatigue 1 month post hospital discharge. Remits after 36 h with full recovery of neurological function. Symptoms persistent for several years. Asymptomatic at hospital discharge
  1. Abnormal values are printed in boldface. All patients with CSF pleocytosis had mostly mononuclear leukocytes. The cut-offs used for SFG Rickettsia IFA were 1:64 for IgM and 1:128 for IgG. Reference values: CRP: < 10 mg/L. CSF-leukocytes: < 5 × 106/L. CSF-protein: 0.15–0.50 g/L. CSF-glucose: 2.2–3.9 mmol/L
  2. SFG spotted fever group, IFA indirect immunofluorescense assay, LNB Lyme neuroborreliosis, CSF cerebrospinal fluid, PCR polymerase chain reaction