borreliae not detected in local EM cluster

August 3, 2005

These are not necessarily the greatest techniques for detecting

borreliosis; PCR of borreliae is not totally reliable in the

experience of the Brorsons for reasons unknown; it would be nice to

see some direct search for antigens; but this is still quite odd,

especially seeing as Pachner has produced EM in primates by injecting

Bb.

===================================================

Clin Infect Dis. 2005 Feb 1;40(3):423-8. Epub 2005 Jan 10.

Microbiologic evaluation of patients from Missouri with erythema

migrans.

Wormser GP, Masters E, Liveris D, Nowakowski J, Nadelman RB, Holmgren

D, Bittker S, D, Wang G, Schwartz I.

Division of Infectious Diseases, Department of Medicine, New York

Medical College, Valhalla, NY 10595, USA. gary_wormser@...

BACKGROUND: Borrelia lonestari infects Amblyomma americanum, the tick

species that is the most common cause of tick bites in southeast and

south-central United States, and this spirochete has been detected in

an erythema migrans (EM)-like skin rash in 1 patient. Therefore, B.

lonestari is considered to be a leading candidate for the etiologic

agent of EM in this region. METHODS: Skin biopsy specimens obtained

from patients from the Cape Girardeau area of Missouri who had EM-

like lesions were cultured in Barbour-Stoenner- medium and

evaluated by polymerase chain reaction (PCR) targeting multiple

genes. Serum specimens were tested by enzyme-linked immunosorbent

assay for antibodies against sonicated whole-cell Borrelia

burgdorferi. Results were compared with those obtained over the same

period for patients from New York State who had EM. RESULTS: B.

lonestari was not detected by PCR in any of 31 skin biopsy specimens

collected from 30 Missouri patients. None of 19 cultures of Missouri

skin samples that were suitable for evaluation were positive for B.

burgdorferi, compared with 89 (63%) of 142 cultures of samples

collected from New York State patients (P<.001). None of the 25

evaluable Missouri patients were seropositive for antibodies against

B. burgdorferi, compared with 107 (75%) of 143 New York State

patients (P<.001). CONCLUSIONS: Neither B. lonestari nor B.

burgdorferi is likely to be the cause of EM-like skin lesions in

patients from the Cape Girardeau area of Missouri. The etiology of

this condition remains unknown.

PMID: 15668867 [PubMed - in process]

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