в таблице 2 какие из маркеров боррелии могут быть неспецифичны и давать ложно-полож. результаты
Antibody Cross-Reactivity in Serodiagnosis of Lyme Disease
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польские врачи считают такие/подобные высыпания патогномичными для лайма - см фото 6 по ссылке:
3.4. Multiple Erythema Migrans (MEM)
The presence of MEM is evidence of spirochaetemia in the body. It can also be the result of multiple bites on a child. The appearance of MEM may be accompanied by general flu-like symptoms, headaches, joint pain, and neurological symptoms. MEM is a rare manifestation of infection in children [10], and is still often unrecognized as one of the clinical forms of Lyme disease [22]. The location of multiple erythema is not related to the tick bite site. Characteristic erythema appears around the injection site, as in distant areas of the skin [7,23]. If the primary lesion is the erythema around the tick bite, the remaining lesions (usually smaller than the original lesion) are satellite lesions (Figure 6)
The diagnosis of MEM, like EM, is a clinical diagnosis; there are no indications that serological tests should be performed in the presence of lesions of such morphology. Patients presenting with EM and MEM should receive adequate treatment, without delays associated with serological testing. In doubtful cases, the lesions should be observed for the next 24–28 h, and evaluated for peripheral enlargement. Serological tests should be performed at least 2 weeks after the onset of MEM [24]. Patients with early disseminated disease who present with multiple erythema migrans lesions are treated the same way as those with a single erythema migrans lesion [11,12,13].
Cutaneous Manifestations of Lyme Borreliosis in Children—A Case Series and Review
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