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Pourquoi le diagnostic de neuroborréliose aiguë reste-t-il difficile? De la physiopathologie au diagnostic en passant par l'abduction et le théorème de Bayes.

par Godefroid, C;Buttafuoco, F;Richard, Thibault ;Goubella, Ahmed ;Vanhaeverbeek, Michel
Référence Revue médicale de Bruxelles, 35, 5, page (440-444)
Publication Publié, 2014-10-01

Article révisé par les pairs

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Résumé :

The diagnosis of acute neuroborreliosis may be difficult if it's regarded as a "classical" infectious disease. Through a clinical case, we illustrate the difficulties met and we suggest two ways of reflexion to assist in the diagnosis:--firstly, we explain how the comprehension of the behavior of the pathogen agent, which is similar to a parasitic behavior, can help to choose and interpret the results of additional tests;--secondly, we develop practically the clinical form of Bayes's theorem to demonstrate the interest of a rational Bayesian and abductive approach which should be preferred to the classical hypothetical and deductive reasoning.