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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)

Parameter Diagnostic LP LP after initiating antibiotic treatment Remarks
Cell count ≤4/μL: 0%
5-30/μL: 1%
> 30/μL: 99%
normalized Increase 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 synthesis IgM > 0%: 70%
IgG > 0%: 20%
IgA > 0%: 1%
May persist for years  
OCBs positive in 70% of neuroborreliosis patients May persist for years Differentiatial diagnosis for multiple sclerosis is necessary
Borrelia AI ≥1.5 positive in > 80% May persist for years Not suitable in suspected reinfection
Borrelia PCR in CSF Positive in 10-30% Negative after appropriate antibiotic treatment  
Lactate <  3.5 mmol/L: 95%
>  3.5 mmol/L: 5%
  
CXCL13 Sensitivity 80 - 100% Normalized after antibiotic treatment Not specific, elevated in CNS lymphoma and inflammation