Penny, You May Be Interested In This One

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I find the last paragraph of this abstract very relevant to two of

your concerns: Osteomyelitis, and uncertainty about whether in

specific cases the cause of disease is borrelia or something else.

Clin Infect Dis. 1994 Nov;19(5):891-6.

Subacute multiple-site osteomyelitis caused by Borrelia burgdorferi.

Oksi J, Mertsola J, Reunanen M, Marjamaki M, Viljanen MK.

Department of Medical Microbiology, Turku University, Finland.

In a pediatric case of severe multiple-site osteomyelitis caused by

Borrelia burgdorferi, the presence of spirochetes in a bone lesion

was documented both by culture and by the polymerase chain reaction

(PCR). Positive PCR results were also obtained with culture fluid

yielding spirochetal growth and with acute-phase serum.

Although the disease evidently was a late manifestation of Lyme

borreliosis, antibodies to B. burgdorferi were low in titer and were

restricted to the IgM class.

The distribution of osteomyelitic lesions in multiple bones and the

positive PCR results obtained with serum argue for hematogenous

spread of the spirochetes.

Before the specific diagnosis was established, the patient received

several potent antimicrobial drugs, without a favorable outcome. In

contrast, therapy with ceftriaxone led to a rapid cure that

persisted thereafter. We conclude that infection due to B.

burgdorferi must be considered a possible cause of subacute

pediatric osteomyelitis.

Publication Types:

Case Reports

PMID: 7893875 [PubMed - indexed for MEDLINE]