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Med Mal Infect. 2019 Mar;49(2):102-111. doi: 10.1016/j.medmal.2019.01.009. Epub 2019 Feb 11.

Values of diagnostic tests for the various species of spirochetes.

Author information

1
IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Aix Marseille Université, 13005 Marseille, France. Electronic address: carole.eldin@gmail.com.
2
Laboratoire de bactériologie, Centre national de référence des Borrelia, faculté de médecine de Strasbourg, hôpitaux universitaires de Strasbourg, 67091 Strasbourg, France.
3
IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Aix Marseille Université, 13005 Marseille, France.
4
Plate-forme de sérologie bactérienne, IHU-Méditerranée Infection, 13005 Marseille, France; Labosud provence biologie, 13117 Martigues, France.
5
IRD, AP-HM, MEPHI, IHU-Méditerranée Infection, Aix Marseille Université, 13005 Marseille, France.

Abstract

Bacteria of the Borrelia burgdorferi sensu lato complex, responsible for Lyme disease, are members of the spirochetes phylum. Diagnostic difficulties of Lyme disease are partly due to the characteristics of spirochetes as their culture is tedious or even impossible for some of them. We performed a literature review to assess the value of the various diagnostic tests of spirochetes infections 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 therefore crucial in the diagnostic process. All currently available diagnostic tools are imperfect, with a potential risk of false positive and false negative results depending on the clinical context. Physicians should always take into consideration the clinical and epidemiological context when Lyme disease, relapsing fever borreliae, syphilis, and leptospirosis are suspected.

KEYWORDS:

Borrelia; Leptospira; Lyme; Spirochetes; Spirochètes; Treponema pallidum

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