Dynamics of Spirochetemia and Early PCR Detection of Borrelia miyamotoi.

We investigated whether Borrelia miyamotoi disease can be detected in its early stage by using PCR for borrelial 16S rRNA, which molecule (DNA or RNA) is the best choice for this test, and whether spirochetes are present in blood during the acute phase of B. miyamotoi disease. A total of 473 patients with a suspected tickborne infection in Yekaterinburg, Russia, in 2009, 2010, and 2015 were enrolled in this study. Blood samples were analyzed by using quantitative PCR or ELISA, and a diagnosis of borreliosis was confirmed for 310 patients. For patients with erythema migrans, 5 (3%) of 167 were positive for B. miyamotoi by PCR; for patients without erythema migrans, 65 (45%) of 143 were positive for B. miyamotoi by PCR. The median concentration for RNA was 3.8 times that for DNA. Median time for detection of B. miyamotoi in blood was 4 days.

A relapsing fever group Borrelia sp. is widely distributed among wild deer in Japan.

A relapsing fever group Borrelia sp. was detected from the blood of wild deer (Cervus nippon) in Japan. The Borrelia sp. was distributed nationwide among deer with an overall prevalence of 26% in blood samples. The prevalence of infection was significantly higher in fawns (48.4%) compared to adult deer (23.6%). Sequencing analysis reveals that this Borrelia sp. belongs to the hard tick-borne relapsing fever borreliae, and that it forms a single lineage based on sequences of the flagellin and glycerophosphodiester phosphodiesterase genes. Borrelial genome copy number was estimated at 8.8 × 103 genome copies/µl of blood. Other hard tick-borne relapsing fever borrelia (e.g. Borrelia miyamotoi) were not detected in deer blood in this study. These findings suggest that wild deer may act as reservoirs for this Borrelia sp. in Japan.

Studies that report unexpected positive blood cultures for Lyme borrelia - are they valid?

Positive blood cultures for Lyme borrelia have been well documented in untreated patients with early Lyme disease. In this report we review the validity of three studies that reported the recovery of Borrelia burgdorferi sensu lato from the blood of a high proportion of patients for whom no evidence was presented, and no claim was made, that the patients had untreated early Lyme disease. In two of the studies the patients had been treated extensively with antibiotics for Lyme disease before the cultures were obtained. Critical evaluation of the three reports suggests that they are invalid. Indeed, two subsequently published studies could not reproduce the results of one of the reports. In a published analysis of another of the reports, investigators from the Centers for Disease Control and Prevention concluded that the cultures were likely to have been contaminated. When the biologic plausibility of recovering borrelia from blood is extremely low, the level of scientific rigor required of a study that claims a positive result should be particularly high.

Tick-Borne Relapsing Fever in Dogs.

BACKGROUND: In the United States, Tick-Borne Relapsing Fever (TBRF) in dogs is caused by the spirochete bacteria Borrelia turicatae and Borrelia hermsii, transmitted by Ornithodoros spp. ticks. The hallmark diagnostic feature of this infection is the visualization of numerous spirochetes during standard blood smear examination. Although the course of spirochetemia has not been fully characterized in dogs, in humans infected with TBRF the episodes of spirochetemia and fever are intermittent. OBJECTIVES: To describe TBRF in dogs by providing additional case reports and reviewing the disease in veterinary and human medicine. ANIMALS: Five cases of privately-owned dogs naturally infected with TBRF in Texas are reviewed. METHODS: Case series and literature review. RESULTS: All dogs were examined because of lethargy, inappetence, and pyrexia. Two dogs also had signs of neurologic disease. All dogs had thrombocytopenia and spirochetemia. All cases were administered tetracyclines orally. Platelet numbers improved and spirochetemia and pyrexia resolved in 4 out of 5 dogs, where follow-up information was available. CONCLUSION AND CLINICAL IMPORTANCE: TBRF is likely underdiagnosed in veterinary medicine. In areas endemic to Ornithodoros spp. ticks, TBRF should be considered in dogs with thrombocytopenia. Examination of standard blood smears can provide a rapid and specific diagnosis of TBRF when spirochetes are observed.

First detection of Borrelia burgdorferi sensu lato DNA in king penguins (Aptenodytes patagonicus halli).

The hard tick Ixodes uriae parasitises a wide range of seabird species in the circumpolar areas of both Northern and Southern hemispheres and has been shown to be infected with Borrelia burgdorferi sensu lato, the bacterial agents of Lyme borreliosis. Although it is assumed that seabirds represent viable reservoir hosts, direct demonstrations of infection are limited to a single study from the Northern hemisphere. Here, the blood of 50 tick-infested adult king penguins (Aptenodytes patagonicus halli) breeding in the Crozet Archipelago (Southern Indian Ocean) was examined for B. burgdorferi sl exposure by serology and for spirochetemia by in vitro DNA amplification. Four birds were found positive by serology, whereas B. burgdorferi sl DNA was detected in two other birds. Our data therefore provide the first direct proof of Borrelia burgdorferi sl spirochetes in seabirds of the Southern hemisphere and indicate a possible reservoir role for king penguins in the natural maintenance of this bacterium. Although the bacterial genetic diversity present in these hosts and the infectious period for tick vectors remain to be elucidated, our results add to a growing body of knowledge on the contribution of seabirds to the complex epizootiology of Lyme disease and the global dissemination of B. burgdorferi sl spirochetes.

Borreliosis, fiebre recurrente causada por espiroquetas. Informe de un caso / Borreliosis: recurrent fever due to spirochetes. Case report

Introducción. Las fiebres recurrentes son un grupo complejo de enfermedades causadas por diversas espiroquetas del género Borrelia, que el hombre adquiere por piquetes de piojos o garrapatas. El propósito de este trabajo es presentar un caso con esta enfermedad. Caso Clínico. Paciente femenino de 12 años de edad, que presentó inicialmente fiebre, cefalea, adenitis cervical y exantema toracoabdominal. La fiebre fue recurrente durante tres meses, con periodos 3 a 5 días e intervalos afebriles de 15 a 21 días. Los resultados de los exámenes de laboratorio fueron negativos para los anticuerpos anti Borrelia burgdorferi. En el frotis de sangre se identificaron espiroquetas. Fue tratada con diversos esquemas de antibióticos y, finalmente, con doxiciclina. Su evolución fue satisfactoria, y tres meses después aún se encuentra asintomática. Conclusiones. En el presente caso se consideró prudente, entre los diagnósticos diferenciales, incluir la posibilidad de fiebre recurrente atribuida a espiroquetemia. La dificultad para establecer el diagnóstico nos muestra la importancia de tener en mente este tipo de infecciones.

Background. Relapsing fever is a complex group of diseases caused by spirochetes of the genus Borrelia transmitted to humans by lice or ticks. The purpose of this study is to present a case of relapsing fever. Case report. A 12-year-old girl with no relevant clinical history was admitted with fever, headache, cervical adenitis, and thoracoabdominal exanthema. She had relapsing fever for 3 to 5 days with 15- to 21-day-intervals of apyrexia during the past 3 months. Laboratory exams were normal or negative including antibodies for Borrelia burdorferi. Peripheral blood smear showed spirochetes. She was treated with various antibiotics and finally doxycycline was added with a good response. The patient is asymptomatic and without sequelae 3 months after treatment. Conclusion. In the case we reported, relapsing fever due to spirochetemia was made during the differential diagnosis. Due to the difficulty in identification, it is important to have a clinical suspicion of this type of infection.

Human intestinal spirochetosis--a review.

Human intestinal spirochetosis (IS) is a condition defined histologically by the presence of spirochetal microorganisms attached to the apical cell membrane of the colorectal epithelium. Intestinal spirochetes comprise a heterogeneous group of bacteria. In humans, Brachyspira aalborgi and Brachyspira pilosicoli predominate. Prevalence rates of IS are low where living standards are high, in contrast to poorly developed areas where IS is common. Homosexuals and HIV-infected individuals are at high risk of being colonized. Clinical significance in individual cases has remained unclear up to now. A review of the literature assumes that invasion of spirochetes beyond the surface epithelium may be associated with gastrointestinal symptoms which respond to antibiotic treatment (metronidazole), whereas individuals lacking this feature may be mostly asymptomatic. Of unknown reason, homosexual and HIV-positive men as well as children are more likely to be symptomatic irrespective of invasion. Rare cases of spirochetemia and multiple organ failure have been reported in critically ill patients with IS.