Borrelia miyamotoi DNA in a patient suspected of Lyme borreliosis

Abstract

Background Clinical manifestations in infection caused by B. miyamotoi can mimick highly variable symptoms of Lyme disease. The aim of our studies was to detect DNA of B. miyamotoi spirochetes in clinical materials from patients suspected of neuroborreliosis(retrospectively).Methods Samples of blood serum and cerebrospinal fluid were collected from 133 patients with clinical manifestations of neuroborreliosis. Diagnosis was established by detection of IgM and / or IgG specific antibodies to B. burgdorferi with ELISA in both sera and CSF. Specificity of positive ELISA results in sera were confirmed with Western-blot test. Bacterial DNA from the collected material was extracted, amplified and sequenced.Results Among 133 patients with clinical manifestations of neuroborreliosis recognized in the years 2010-2018., DNA of B. miyamotoi was detected in CSF from 1 (0.8%) patient with extraocular optic neuritis of the left eye (GenBank accession No. MK674170 and MK674171).Conclusion Detection of B. miyamotoi in patients with central nervous system infections, will allow a better understanding of the epidemiology of infections caused by Borrelia sp. spirochetes. Patients with neurological symptoms and questionable serological findings are a serious diagnostic problem, due to failure to meet the criteria for neuroboreliosis. This indicates the need for further studies of patients with signs of CNS infection.

Borrelia miyamotoi—An Emerging Human Tick-Borne Pathogen in Europe

“…In Europe, several single cases of BMD have been described [ 13 , 14 , 93 , 94 , 95 , 96 ]. Human cases of a positive PCR for B. miyamotoi in Europe are summarized in Table 2 .…”

“…In turn, BMD-associated neuroborreliosis in an immunocompromised patient was found in 2015 in Germany [ 93 ]. In a preliminary report, one case of BMD was demonstrated in the course of neuroborreliosis in Poland [ 96 ]. A human case of B. miyamotoi infection was diagnosed in Austria as well ( Table 2 ).…”

“…The authors of the report point to patients with neurological symptoms and questionable serological findings presenting a serious diagnostic problem. This indicates the need for further studies of patients with signs of central nervous system infection [ 96 ]. In Germany, another case of B. miyamotoi infection of the CNS resembling neuroborreliosis was investigated [ 93 ] ( Figure 2 ).…”

“…In ELISA and a confirmatory Western blot, specific antibodies against GlpQ protein, as a non-reactive antigen from B. burgdorferi s.l. [ 65 , 94 , 98 ], in human serum [ 10 , 65 , 96 , 98 ] and in CSF samples [ 94 ] were used. Sometimes, however, GlpQ-based B. miyamotoi serology as a single marker does not hold specificity or sensitivity [ 13 , 99 ].…”

“…However, the glpQ gene was most often tested in combination with other genes or individually by qPCR. To determine the B. miyamotoi type, nested PCR [ 96 ] or sequencing [ 95 , 97 ] is used.…”