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Table 7 CSF findings in patients with neuroborreliosis

From: S1 guidelines “lumbar puncture and cerebrospinal fluid analysis” (abridged and translated version)

ParameterDiagnostic LPLP after initiating antibiotic treatmentRemarks
Cell count≤4/μL: 0%
5-30/μL: 1%
> 30/μL: 99%
normalizedIncrease may indicate reinfection
Cell type- lymphocytes:
- activated lymphocytes or
Plasma cells: up to 20%
normalized 
Albumin ratio< 8 × 10−3: 1%
8-32 × 10− 3: 99%
normalized 
Quantitative IgG, IgA, and IgM synthesisIgM > 0%: 70%
IgG > 0%: 20%
IgA > 0%: 1%
May persist for years 
OCBspositive in 70% of neuroborreliosis patientsMay persist for yearsDifferentiatial diagnosis for multiple sclerosis is necessary
Borrelia AI ≥1.5positive in > 80%May persist for yearsNot suitable in suspected reinfection
Borrelia PCR in CSFPositive in 10-30%Negative after appropriate antibiotic treatment 
Lactate<  3.5 mmol/L: 95%
>  3.5 mmol/L: 5%
  
CXCL13Sensitivity 80 - 100%Normalized after antibiotic treatmentNot specific, elevated in CNS lymphoma and inflammation