We have a patient (10 year’s old boy) who was infected 2 months before the first treatment. The patient was treated firstly with Azax (Azithromicyn) and then with Zinnate (Cephalosporin). Two months after the applied treatment the IgM levels, which are useful for confirming stage 1 (acute phase of the disease) are still relatively high and IgG test is negative.
Serology is not a marker for therapy success in Lyme disease! If early Lyme disease is being treated short after infection (i.e. at the onset of clinical symptoms like erythema migrans), the IgG switch may not occur. IgM as a marker of primary immune response, however, may persist for years, even after successful treatment. A simple antibody titre is indicative for a Borrelia infection (not for Lyme disease!), but confirmation by immunoblot is highly recommended to rule out non-specific reactions in the ELISA.
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