Skip to main content

Advertisement

Log in

Isolation of Borrelia burgdorferi sensu lato from blood of adult patients with borrelial lymphocytoma, Lyme neuroborreliosis, Lyme arthritis and acrodermatitis chronica atrophicans

  • Brief Report
  • Published:
Infection Aims and scope Submit manuscript

Abstract

Background

Reports on patients with European Lyme borreliosis in whom borreliae were isolated from the blood are rare and nearly exclusively limited to those with solitary or multiple erythema migrans. Here we report on patients with other manifestations of Lyme borreliosis in whom borreliae were isolated from their blood.

Patients and methods

This is a retrospective review of the medical files of patients diagnosed with borrelial lymphocytoma, Lyme neuroborreliosis, Lyme arthritis and acrodermatitis chronica atrophicans at the Department of Infectious Diseases of the UMC Ljubljana, Slovenia, for whom a borrelia blood culture was ordered. The clinical features of patients whose blood culture tested positive for Borrelia burgdorferi sensu lato were reviewed, and the association between the proportion of patients with a positive blood culture and various clinical manifestations was examined.

Results

Borrelia burgdorferi sensu lato was isolated from the blood of 1/53 (1.9%) patients with borrelial lymphocytoma, 6/176 (3.4%) patients with Lyme neuroborreliosis, 1/13 (7.7%) patients with Lyme arthritis, and 3/200 (1.5%) patients with acrodermatitis chronica atrophicans. The time interval from the onset of symptoms attributed to Lyme borreliosis and the blood culture ranged from 1 day to >2 years (median 3.5 weeks). At the time of the blood culture, erythema migrans was present in 4/11 (36.4%) borrelia blood culture-positive patients, i.e. in the patient with borrelial lymphocytoma, the patient with Lyme arthritis and the 2/6 patients with Lyme neuroborreliosis. Only two of these 11 (18.2%) patients had fever at the time of the blood culture.

Conclusions

In European patients with Lyme borreliosis, borreliae can be cultured from the blood not only early in the course of the disease but also occasionally later during disease progression.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Wormser GP, McKenna D, Carlin J, Nadelman RB, Cavaliere LF, Holmgren D, Byrne DW, Nowakowski J. Hematogenous dissemination in early Lyme disease. Ann Intern Med. 2005;142:751–5.

    PubMed  Google Scholar 

  2. Wormser GP, Bittker S, Cooper D, Nowakowsky J, Nadelman RB, Pavia C. Yield of large-volume blood cultures in patients with early Lyme disease. J Infect Dis. 2001;184:1070–2.

    Article  PubMed  CAS  Google Scholar 

  3. Maraspin V, Ruzić-Sabljić E, Cimperman J, Lotrič-Furlan S, Jurca T, Strle F. Isolation of Borrelia burgdorferi sensu lato from blood of patients with erythema migrans. Infection. 2001;29:65–70.

    Article  PubMed  CAS  Google Scholar 

  4. Arnez M, Ruzić-Sabljić E, Ahcan J, Radsel-Medvescek A, Pleterski-Rigler D, Strle F. Isolation of Borrelia burgdorferi sensu lato from blood of children with solitary erythema migrans. Pediatr Infect Dis J. 2001;20:251–5.

    Article  PubMed  CAS  Google Scholar 

  5. Ruzić-Sabljić E, Maraspin V, Lotric-Furlan S, Jurca T, Logar M, Pikelj-Pecnik A, Strle F. Characterization of Borrelia burgdorferi sensu lato strains isolated from human material in Slovenia. Wien Klin Wochenschr. 2002;114:544–50.

    PubMed  Google Scholar 

  6. Steere AC. Lyme disease. N Engl J Med. 2001;345:115–25.

    Article  PubMed  CAS  Google Scholar 

  7. Stanek G, Strle F. Lyme borreliosis. Lancet. 2003;362:1639–47.

    Article  PubMed  Google Scholar 

  8. Arnez M, Pleterski-Rigler D, Ruzić-Sabljić E, Strle F. Simultaneous isolation of Borrelia burgdorferi sensu lato from blood and cerebrospinal fluid in three patients with multiple erythema migrans. J Pediatr Infect Dis. 2006;1:123–5.

    Google Scholar 

  9. Strle F, Stanek G. Clinical manifestations and diagnosis of Lyme borreliosis. Curr Probl Dermatol. 2009;37:51–110

    Article  PubMed  Google Scholar 

  10. Nadelman RB, Pavia CS, Magnarelli LA, Wormser GP. Isolation of Borrelia burgdorferi from the blood of seven patients with Lyme disease. Am J Med. 1990;88:21–6.

    Article  PubMed  CAS  Google Scholar 

  11. Viljanen MK, Oksi J, Salomaa P, Skurnik M, Peltonen R, Kalimo H. Cultivation of Borrelia burgdrferi from the blood and a subcutaneous lesion of a patient with relapsing febrile nodular nonsuppurative panniculitis. J Infect Dis. 1992;165:596–7.

    PubMed  CAS  Google Scholar 

  12. Nowakowski J, McKenna D, Nadelman RB, Bittker S, Cooper D, Pavia C, Holmgren D, Visintainer P, Wormser GP. Blood cultures for patients with extracutaneous manifestations of Lyme disease in the United States. Clin Infect Dis. 2009;49:1733–5.

    Article  PubMed  Google Scholar 

  13. Institute of Public Health. Surveillance report on notifiable communicable diseases in Slovenia in year 2009.

  14. Preac-Mursic V, Wilske B, Shierz G. European Borrelia burgdorferi isolated from humans and ticks. Culture conditions and antibiotic susceptibility. Zentralbl Mikrobiol Hyg A. 1986;263:112–8.

    CAS  Google Scholar 

  15. Ruzić-Sabljić E, Arnez M, Lotric-Furlan S, Maraspin V, Cimperman J, Strle F. Genotypic and phenotypic characterisation of Borrelia burgdorferi sensu lato strains isolated from human blood. J Med Microbiol. 2001;50:896–901.

    PubMed  Google Scholar 

  16. Postic D, Assous MV, Grimont PAD, Baranton G. Diversity of Borrelia burgdorferi sensu lato evidenced by restriction fragment lenght polymorphism of rrf (5S)–rrl (23S) intergenic spacer amplicons. Int J Syst Bacteriol. 1994;44:743–52.

    Article  PubMed  CAS  Google Scholar 

  17. Bigi S, Aebi C, Nauer C, Bigler S, Steinlin M. Acute transverse myelitis in Lyme neuroborreliosis. Infection. 2010;38:413–6.

    Article  PubMed  CAS  Google Scholar 

  18. Dolan MC, Piesman J, Schneider BS, Schriefer M, Brandt K, Zeidner NS. Comparison of disseminated and nondisseminated strains of Borrelia burgdorferi sensu stricto in mice naturally infected by tick bite. Infect Immun. 2004;72:5262–6.

    Article  PubMed  CAS  Google Scholar 

  19. Strle F, Ruzić-Sabljić E, Cimperman J, Lotric-Furlan S, Maraspin V. Comparison of findings for patients with Borrelia garinii and Borrelia afzelii isolated from cerebrospinal fluid. Clin Infect Dis. 2006;43:704–10.

    Article  PubMed  CAS  Google Scholar 

  20. Picken MM, Picken RN, Han D, Cheng Y, Strle F. Single-tube nested polymerase chain reaction assay based on flagellin gene sequences for detection of Borrelia burgdorferi sensu lato. Eur J Clin Microbiol Infect Dis. 1996;6:489–98.

    Article  Google Scholar 

  21. Seinost G, Golde WT, Berger BW, Dunn JJ, Qiu D, Dunkin DS, Dykhuizen DE, Luft BJ, Dattwyler RJ. Infection with multiple strains of Borrelia burgdorferi sensu stricto in patients with Lyme disease. Arch Dermatol. 1999;135:1329–33.

    Article  PubMed  CAS  Google Scholar 

  22. Cerar T, Ruzić-Sabljić E, Glinsek U, Zore A, Strle F. Comparison of PCR methods and culture for the detection of Borrelia spp. in patients with erythema migrans. Clin Microbiol Infect. 2008;14:653–8.

    Article  PubMed  CAS  Google Scholar 

  23. Ružič-Sabljić E, Arnez M, Logar M, Maraspin V, Lotric-Furlan S, Cimperman J, Strle F. Comparison of Borrelia burgdorferi sensu lato strains isolated from specimens obtained simultaneously from two different sites of infection in individual patients. J Clin Microbiol. 2005;43:2194–200.

    Article  PubMed  Google Scholar 

  24. Fallon BA, Keilp JG, Corbera KM, Petkova E, Britton CB, Dwyer E, Slavov I, Cheng J, Dobkin J, Nelson DR, Sackeim HA. A randomized, placebo-controlled trial of repeated IV antibiotic therapy for Lyme encephalopathy. Neurology. 2008;70:992–1003.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

F. Strle received funding from the Ministry of Science and Technology of the Republic of Slovenia (grant P3-0296). The funding source played no role in the preparation of the manuscript.

Conflict of interest

There is no actual or potential conflict of interest related to this article.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to V. Maraspin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Maraspin, V., Ogrinc, K., Ružić-Sabljić, E. et al. Isolation of Borrelia burgdorferi sensu lato from blood of adult patients with borrelial lymphocytoma, Lyme neuroborreliosis, Lyme arthritis and acrodermatitis chronica atrophicans. Infection 39, 35–40 (2011). https://doi.org/10.1007/s15010-010-0062-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s15010-010-0062-8

Keywords

Navigation