title: Human necrotizing splenitis caused by Borrelia burgdorferi.
abstract: A 25-year-old Hispanic male presented to the emergency room with complaints of severe left upper quadrant pain. Physicians determined that the patient had an acute inflammatory process with a possible diagnosis of splenic abscess. A splenectomy was performed. Histologic examination of the tissue sections revealed extensive necrosis and inflammation, but no etiologic agent was discernible. Microbiologic cultures of the tissue had negative results. A Dieterle silver stain revealed an overwhelming number of spirochetal bacteria most closely resembling Borrelia spp. The patient's serum was tested for serologic evidence of antibody to Borrelia burgdorferi with the following results; by indirect fluorescent antibody 1:32; by enzyme-linked immunosorbent assay for IgM, 1:320; and Western blotting had positive results for the presence of B. burgdorferi outer-surface protein antibodies. This is the first human case report of an acute necrotizing splenitis resulting from B. burgdorferi.
authors.affiliation: Department of Pathology, Mount Sinai Hospital, Hartford, Connecticut 06112.
authors.forename: E L
authors.initials: EL
authors.lastname: Rank
authors.forename: S M
authors.initials: SM
authors.lastname: Dias
authors.forename: J
authors.initials: J
authors.lastname: Hasson
authors.forename: P H
authors.initials: PH
authors.lastname: Duray
authors.forename: R C
authors.initials: RC
authors.lastname: Johnson
authors.forename: L A
authors.initials: LA
authors.lastname: Magnarelli
authors.forename: R D
authors.initials: RD
authors.lastname: Fister
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000032:analysis*; D015153:Blotting, Western; D001898:Borrelia / Q000276:immunology*; D004591:Electrophoresis, Polyacrylamide Gel; D004797:Enzyme-Linked Immunosorbent Assay; D005455:Fluorescent Antibody Technique; D006801:Humans; D008193:Lyme Disease / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D008297:Male; D012698:Serologic Tests; D013156:Splenectomy; D013158:Splenic Diseases / Q000382:microbiology* / Q000473:pathology / Q000601:surgery
chemical_list: D000907:Antibodies, Bacterial