Pathogens
Diagnosis-Treatment Discordance in Suspected Lyme Neuroborreliosis: A Retrospective Cohort Study from a Romanian Tertiary Centre (2008-2025)
By Cheran CA, Tirlescu LG, Panciu AM and 1 others.
Abstract
Background
European and Romanian recommendations for Lyme neuroborreliosis (LNB) emphasise cerebrospinal fluid (CSF) pleocytosis and a positive intrathecal antibody index (IAI) for diagnostic confirmation. We assessed whether antibiotic treatment in suspected LNB aligns with diagnostic recommendations.
Methods
We conducted a retrospective, single-centre cohort study of patients with suspected LNB between 2008 and 2025, all with positive first-tier ELISA (enzyme-linked immunosorbent assay) Borrelia serology. Patients were classified as confirmed, probable, possible, or ruled-out LNB based on clinical presentation, serology, and CSF findings. We assessed factors associated with antibiotic treatment and temporal changes in diagnostic work-up and treatment patterns.