What are the cerebrospinal fluid (CSF) characteristics of Lyme meningitis?

Updated: Jul 16, 2019
  • Author: Rodrigo Hasbun, MD, MPH; Chief Editor: Michael Stuart Bronze, MD  more...
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In patients with Lyme meningitis, the CSF is characterized by low-grade lymphocytic pleocytosis, low glucose levels, and elevated protein levels. Oligoclonal bands reactive to B burgdorferi antigens may be present. Demonstration of the specific antibody to B burgdorferi aids in the diagnosis.

Comparison between the antibody response in the CSF and that in the serum is a helpful diagnostic test. A CSF-to-serum ratio greater than 1 suggests intrathecal antibody production and neuroborreliosis.

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