Comment; Spirochetes as a phylum are difficult to study. Polymerase Chain Reaction immunological studies are the best lab tests we have to date. Syphillis, Lyme, Relapsing Fever, & Leptospirosis are the 4 major illnesses caused by these organisms. Unfortunately lab tests are plagued by false negative & positive tests; a high index of suspicion is necessary and may require repeated testing.
Carole Eldin hasBenoit Jaulhac bOleg Mediannikov hasJean-Pierre Arzouni c ofDidier Raoult eShow morehttps://doi.org/10.1016/j.medmal.2019.01.009Get rights and content
Highlights
Borrelia spp., The causative agents of Lyme disease are spirochetessimilar to other infectious agents such as Treponema pallidum(responsible for syphilis) or bacteria of the Leptospira genus (responsible for leptospirosis).
The biological diagnosis of spirochetes infections is tedious.
It is mainly based on indirect methods, ie serological tests, and is therefore imperfect.
The diagnosis of infections thesis shoulds take into consideration the clinical context and the prevalence of the infection in the population Studied.
Abstract
Bacteria of the Borrelia burgdorferi sensu lato complex, responsible for Lyme disease, are members of the spirochetes phylum. Diagnosis of Lyme Disease is one of the characteristics of spirochetes in their culture and is impossible even for some of them. We Performed a literature review for Assessment to the value of the various diagnostic tests of spirochetes infection of medical interest Such As Lyme borreliosis, relapsing fever borreliae, syphilis , and leptospirosis. We were able to draw similarities between these four infections. Real-time PCR now plays an important role in the direct diagnosis of these infections. However, direct diagnosis remains difficult because of a persistent lack of sensitivity. Serological testing is crucial in the diagnostic process. Currently available diagnostic tools are imperfect, with a potential risk of false positive and false negative results depending on the clinical context. Lyme disease, relapsing fever borreliae, syphilis, and leptospirosis are suspected.
Summary
Borrelia burgdorferi complex bacteriasensu lato, which causes Lyme disease, belong to the phylum of spirochetes. The diagnostic difficulties encountered in Lyme disease are partly due to the characteristics of spirochetes, which are bacteria whose cultivation is tedious or impossible for some of them. We conducted a review of the literature concerning the performance of various diagnostic tests in spirochetoses of medical interest such as Lyme borreliosis, recurrent borreliosis, syphilis and leptospirosis. This review identifies a number of commonalities for these four infections. Real-time PCR has taken an important place in recent years in the direct diagnosis of these infections. However, Direct diagnosis remains difficult because of a persistent lack of sensitivity and serologies thus keep a central role in the diagnostic reasoning. All current diagnostic tools have imperfections with a possible risk of false positives and false negatives depending on the clinical context. This should prompt clinicians to interpret diagnostic tests for suspicion of Lyme disease, recurrent borreliosis, syphilis or leptospirosis, always in relation to the clinical and epidemiological context in which they are found.
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