##submission.abstract##
With interest we read the article by Gaudo et al. about a 4-
year-old female with a mitochondrial disorder (MID) due to
a compound heterozygous variant in POLG1 for whom the
authors claimed that Borreliosis or ceftriaxone had worsened
the phenotype [1]. We have the following comments
and concerns.
The main shortcoming of the study is that the diagnosis
Borreliosis is questionable. For diagnosing acute Borreliosis
not only IgM antibodies but also IgG antibodies against
Borrelia burgdorferi need to be elevated in the serum. We
also should know with which symptoms and signs Borreliosis
manifested clinically, if Borrelia antibodies were also
elevated in the cerebro-spinal fluid (CSF), if there was pleocytosis,
and if neuroborreliosis was diagnosed. If Borreliosis
was diagnosed erroneously, there was no indication for ceftriaxone.