Possible Use of a Scoring System in the Diagnosis of Lyme Borreliosis

Overview

The authors discuss the possible use of a scoring system when assessing the correct diagnosisof Lyme borreliosis (LB). Its criteria are based on analysis of anamnestic data, the clinicalpicture and monitoring of laboratory examinations of patients with regard to data in theliterature (Burrascano 1995). The diagnosis of LB was assessed in this way in 1148 patientsfollowed up in the welfare centre at the Infectious Diseases Clinic, Faculty Hospital Plzeň in1996-1998. In the thus created system a score above 10 points confirmed LB, when the valueswere between 7 and 10 the disease was probable, when the score was below 7 it was unlikely.In patients with verified and notified LB with a typical clinical picture the score had thefollowing values: early dermal stage - erythema migrans on average 13.9 points (not confirmed10.2 points), acute neuroborreliosis 14.2 points (4.6), arthritis 13.9 points (4.7), cardiac 11.2points (4.2). In notified cases there is a significantly higher score, significance p < 0.01.

Key words:
Lyme borreliosis - incidence - case-history - clinical diagnosis - serological diagnosis- scoring system - antibiotic treatment.