Cultivation of Borrelia burgdorferi from the blood of two patients with erythema migrans lesions lacking extracutaneous signs and symptoms of Lyme disease

Isolation of Borrelia burgdorferi Sensu Lato from Blood of Patients with Erythema Migrans

“…A literature search revealed that the frequency of isolation of spirochetes from the blood of patients with EM was low, ranging from 2.5-5.5% in the majority of reports; in some reports, however, it was as high as 21% [3,4,6,[21][22][23][24]. Besides low incidence of spirochetemia there are several other possible explanations for the low yield of recovery of B. burgdorferi sensu lato from blood, including the possibility of intermittent bacteremia, insufficient volume of the cultured blood associated with low concentration of borreliae in blood, an inadequate transport and unique differences in dissemination patterns in sensu stricto versus sensu lato strains of borreliae.…”

“…Therefore very scant information has been available on the clinical significance of spirochetemia; the data have been nearly entirely limited to American findings. A literature search revealed that B. burgdorferi sensu lato has been recovered from blood of patients with EM [3][4][5][6][21][22][23][24] and also from patients without skin rash, two of whom had facial palsy [23], one had relapsing febrile nodular nonsuppurative panniculitis [26] and the other had a virus-like febrile illness [23]. Of the patients with EM and spirochetemia, the majority had associated systemic symptoms and positive serologic tests, and in some of them persistent complaints were observed 6 months after treatment with oral antibiotics [22,23].…”

Hematogenous dissemination in early Lyme disease

“…Spread through the blood stream had long been hypothesized as the major route of dissemination [2], but this concept could not be established because studies in which blood cultures were performed resulted in yields of ≤ 5% [3][4][5][6][7][8][9]. On the other hand, the existence of non-hematogenous routes of dissemination were supported by certain observational and experimental data.…”

“…In prior attempts to culture borrelia from the blood of patients with Lyme borreliosis often only a very small quantity of blood or a blood component was cultured, typically ≤ 1 mL [4][5][6]8]. In adult patients this volume of blood would be considered insufficient to detect bacteremia due to more conventional pathogens, such as Staphylococcus aureus or Escherichia coli, because of the small number of microorganisms present in the blood of bacteremic patients.…”

Tick‐borne diseases in transfusion medicine

“…Transmission by blood transfusion, however, remains a possibility (Bove, 1990; Goldman & Blajchman, 1991). Spirochaetaemia may occur in the absence of significant clinical symptoms (Nadelman et al ., 1990a; Berger et al ., 1994), and therefore can remain undetected at the time of blood donation. Numerous studies have demonstrated the occurrence of IgM and IgG seropositive blood donors around the world (Bohme et al ., 1992a; Cable et al ., 1993; Pierer et al ., 1993; Christiann et al ., 1997; Badon et al ., 2000).…”