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Isolation of Borrelia burgdorferi from the blood of seven patients with lyme disease

  • Robert B. Nadelman
    Correspondence
    Requests for reprints should be addressed to Robert B. Nadelman, M.D., Westchester County Medical Center, Division of Infectious Diseases, Macy Pavilion 209SE, Valhalla, New York 10595.
    Affiliations
    Department of Medicine, Division of Infectious Diseases (RBN, CSP, GPW), New York Medical College, Valhalla, New York USA

    Connecticut Agriculture Experiment Station (LAM), New Haven, Connecticut USA
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  • Charles S. Pavia
    Affiliations
    Department of Medicine, Division of Infectious Diseases (RBN, CSP, GPW), New York Medical College, Valhalla, New York USA

    Connecticut Agriculture Experiment Station (LAM), New Haven, Connecticut USA
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  • Louis A. Magnarelli
    Affiliations
    Department of Medicine, Division of Infectious Diseases (RBN, CSP, GPW), New York Medical College, Valhalla, New York USA

    Connecticut Agriculture Experiment Station (LAM), New Haven, Connecticut USA
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  • Gary P. Wormser
    Affiliations
    Department of Medicine, Division of Infectious Diseases (RBN, CSP, GPW), New York Medical College, Valhalla, New York USA

    Connecticut Agriculture Experiment Station (LAM), New Haven, Connecticut USA
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      Abstract

      purpose: Borrelia burgdorferi, the etiologic agent of Lyme disease, has rarely been successfully cultured from blood. We report on seven patients from Westchester County, New York, with B. burgdorferi bacteremia diagnosed between April 1987 and August 1987.
      patients and methods: One hundred thirty-two attempts to isolate spirochetes were made on blood specimens obtained from 104 patients. Twenty-two of these specimens were obtained from nine patients who had recently been bitten by Ixodes ticks but who were asymptomatic. Heparinized blood or serum specimens (0.2 to 0.4 mL) were inoculated onto 6 mL of modified Barbour-Stoenner-Kelly medium. Lyme serology was performed by enzyme-linked immunosorbent polyvalent, IgM, and IgG assays, fluorescent immunoassay, and microhemag-glutination.
      results: Four of the seven patients had erythema migrans, two had facial nerve palsy, and one had a flu-like syndrome without rash. These patients represented 21% (four of 19) of all patients with the characteristic skin lesion who had blood cultures for B. burgdorferi, and 40% (two of five) of all those with facial nerve palsy. Serologic testing was frequently nonreactive; two patients had no detectable antibody on multiple sera by five different assays. All patients improved with antibiotic treatment, and had negative subsequent blood cultures, but five of seven had persistent complaints after completion of therapy.
      conclusion: Culturing blood for B. burgdorferi may be useful in confirming the diagnosis of Lyme disease in selected patients. Use of spirochete blood cultures may facilitate a better understanding of the pathogenesis and natural history of Lyme disease.
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      References

        • Steere AC
        • Broderick TE
        • Malawista SE
        Erythema chronicum migrans and Lyme arthritis: epidemiological evidence for a tick vector.
        Am J Epidemiol. 1978; 108: 312-321
        • Steere AC
        • Malawista SE
        Cases of Lyme disease in the United States: locations correlated with distribution of Ixodes dammini.
        Ann Intern Med. 1979; 91: 730-733
        • Steere AC
        • Grodzicki RL
        • Kornblatt AN
        • et al.
        The spirochetal etiology of Lyme disease.
        N Engl J Med. 1983; 308: 733-740
        • Williams CL
        • Curran AS
        • Lee AC
        Epidemiology of Lyme disease in Westchester County, New York.
        NY Med Q. 1985; 5: 89-91
        • Bowen GS
        • Griffin M
        • Hayne C
        • Slade J
        • Schulze TL
        • Parkin W
        Clinical manifestations and descriptive epidemiology of Lyme disease in New Jersey, 1978 to 1982.
        JAMA. 1984; 251: 2236-2240
        • Steere AC
        • Hutchinson GJ
        • Rahn DW
        • et al.
        Treatment of the early manifestations of Lyme disease.
        Ann Intern Med. 1983; 99: 22-26
        • Reik L
        • Burgdorfer W
        • Donaldson JO
        Neurologic abnormalities in Lyme disease without erythema chronicum migrans.
        Am J Med. 1986; 81: 73-78
        • Clark JR
        • Carlson RD
        • Pachner AR
        • Sasaki CT
        • Steere AC
        Facial paralysis in Lyme disease.
        Laryngoscope. 1985; 95: 1341-1345
        • Shrestha M
        • Grodzicki RL
        • Steere AC
        Diagnosing early Lyme disease.
        Am J Med. 1985; 78: 235-240
        • Benach JL
        Serological responses to the Lyme disease spirochete.
        NY Med Q. 1985; 5: 107-109
        • Barbour A
        Isolation and cultivation of Lyme disease spirochetes.
        Yale J Biol Med. 1984; 57: 521-525
        • Benach JL
        • Bosler EM
        • Hanrahan JP
        • et al.
        Spirochetes isolated from the blood of two patients with Lyme disease.
        N Engl J Med. 1983; 308: 740-742
        • Rawlings JA
        • Fournier PV
        • Teltow GJ
        Isolation of Borrelia spirochetes from patients in Texas.
        J Clin Microbiol. 1987; 25: 1148-1150
        • Neubert U
        • Krampitz HE
        • Engl H
        Microbiological findings in erythema (chronicum) migrans and related disorders.
        Zentralbl Bakteriol Hyg [A]. 1986; 263: 237-252
        • Preac-Mursic V
        • Wilske B
        • Pfister HW
        • Einhaupl K
        Repeated isolations of spirochetes from the cerebrospinal fluid of a patient with meningoradiculitis Bannwarth.
        Eur J Microbiol. 1984; 3: 564-565
        • Berger BW
        • Kaplan MH
        • Rothenberg IR
        • Barbour AG
        Isolation and characterization of the Lyme disease spirochete from the skin of patients with erythema chronicum migrans.
        J Am Acad Dermatol. 1985; 13: 444-449
        • Snydman DR
        • Schenkein DP
        • Berardi VP
        • Lastavica CC
        • Pariser KM
        Borrelia burgdorferi in joint fluid in chronic Lyme arthritis.
        Ann Intern Med. 1986; 104: 798-800
        • Pavia CS
        • Bittker S
        Assessment of in vitro growth of Borrelia burgdorferi by tritiated adenine incorporation.
        Ann NY Acad Sci. 1988; 539: 410-413
        • Pavia CS
        • Niederbuhl CJ
        Experimental infection of inbred guinea pigs with Treponema pallidum: development of lesions and formation of antibodies.
        Genitourin Med. 1985; 61: 75-81
        • Magnarelli LA
        • Meegan JM
        • Anderson JF
        • Chappell WA
        Comparison of an indirect fluorescent-antibody test with an enzyme-linked immunosorbent assay for serological studies of Lyme disease.
        J Clin Microbiol. 1984; 20: 181-184
        • Pavia CS
        • Bittker S
        Rapid detection of Lyme disease by an indirect hemagglutination technique.
        (abstr)in: Proceedings of the American Society for Microbiology, MiamiMay 8–13, 1988
        • Hudson L
        • Hay FC
        Practical immunology.
        in: Blackwell Scientific Publications, Oxford1980: 135-136
        • Barbour AG
        • Schrumpf ME
        Polymorphisms of major surface proteins of Borrelia burgdorferi.
        Zentralbl Bakteriol Hyg [A]. 1986; 263: 83-91
        • Barbour AG
        • Hayes SF
        • Heiland RA
        • Schrumpf ME
        • Tessier SL
        A Borrelia-specific monoclonal antibody binds to a flagellar epitope.
        Infect Immun. 1986; 52: 549-554
        • Barbour AG
        • Tessier SL
        • Hayes SF
        Variation in a major surface protein of Lyme disease spirochetes.
        Infect Immun. 1984; 45: 94-100
        • Johnson RC
        • Kodner C
        • Russell M
        Passive immunization of hamsters against experimental infection with the Lyme disease spirochete.
        Infect Immun. 1986; 53: 713-714
        • Pennell DR
        • Wand PJ
        • Schell RF
        Evaluation of quantitative fluorescence immunoassay (FIAX) for detection of serum antibody to Borrelia burgdorferi.
        J Clin Microbiol. 1987; 25: 2218-2220
        • Pavia CS
        Thymocyte-dependent immunity to toxoplasmosis in the normal and immunocompromised guinea-pig host.
        Parasite Immunol. 1987; 9: 205-218
        • Austrian R
        • Gold J
        Pneumococcal bacteremia with special reference to bacteremic pneumococcal pneumonia.
        Ann Intern Med. 1964; 60: 759-776
        • Wilske B
        • Preac-Mursic V
        • Schierz G
        Antigenic heterogeneity of European Borrelia burgdorferi strains isolated from patients and ticks.
        Lancet. 1985; I (letter): 1099
        • Barbour AG
        • Heiland RA
        • Howe TR
        Heterogeneity of major proteins in Lyme disease Borrelia: a molecular analysis of North American and European isolates.
        J Infect Dis. 1985; 152: 478-484
        • Schwan TG
        • Burgdorfer W
        Antigenic changes of Borrelia burgdorferi as a result of in vitro cultivation.
        J Infect Dis. 1987; 156 (letter): 852-853
        • Berardi VP
        • Weeks KE
        • Steere AC
        Serodiagnosis of early Lyme disease: analysis of IgM and IgG antibody responses by using an antibody-capture enzyme immunoassay.
        J Infect Dis. 1988; 158: 754-760
        • Grodzicki RL
        • Steere AC
        Comparison of immunoblotting and indirect enzyme-linked immunosorbent assay using different antigen preparations for diagnosing early Lyme disease.
        J Infect Dis. 1988; 157: 790-797
        • Pachner AR
        • Steere AC
        The triad of neurologic manifestations of Lyme disease: meningitis, cranial neuritis, and radiculoneuritis.
        Neurology. 1985; 35: 47-53
        • Lavoie PE
        • Lane RS
        • Murray RH
        Seronegative Lyme borreliosis in three Californians with late manifestations.
        Arthritis Rheum. 1987; 30: S36
        • Dattwyler RJ
        • Halperin JJ
        Failure of tetracycline therapy in early Lyme disease.
        Arthritis Rheum. 1987; 30: 448-450
        • Tenover FC
        Diagnostic deoxyribonucleic acid probes for infectious disease.
        Clin Microbiol Rev. 1988; 1: 82-101
        • Johnson SE
        • Klein GC
        • Schmid GP
        • Feeley JC
        Susceptibility of the Lyme disease spirochete to seven antimicrobial agents.
        Yale J Biol Med. 1984; 57: 549-553
        • Mursic VP
        • Wilske B
        • Schierz G
        • Holmburger M
        • Suss E
        In vitro and in vivo susceptibility of Borrelia burgdorferi.
        Eur J Clin Microbiol. 1987; 6: 424-426
        • Dattwyler RJ
        • Halperin JJ
        • Pass H
        • Luft BJ
        Ceftriaxone as effective therapy in refractory Lyme disease.
        J Infect Dis. 1987; 155: 1322-1325