title: [Borrelia burgdorferi-induced pseudolymphoma with pathogen cultivation in an HIV-1 positive patient].
abstract: Cutaneous symptoms and skin diseases are common findings in almost all HIV-1-positive patients. In many cases the clinical presentation and course of the skin diseases are atypical, and occasionally the development of the appropriate circulating antibodies is lacking or impaired. In this report we present a patient seen in our multidisciplinary outpatient clinic for HIV patients. This patient had a Borrelia burgdorferi infection with an unusual course. The acute inflammatory phase of the arthropod reaction was maintained over a period of 9 months with development into pseudolymphoma showing unusual cytological characteristics. Immunohistological evaluation revealed an almost complete lack of T-helper and Langerhans cells, but an increased number of activated cytotoxic cells with class II antigen expression. A marked serological response was observed on IgG-ELISA and in the IgG-immunofluorescence test. Borrelia burgdorferi was cultured in vitro from a skin biopsy of the involved area. To our knowledge this is the first reported case of skin borreliosis in an HIV-1-positive patient.
authors.affiliation: Universitäts-Hautklinik und Poliklinik, Freien Universität Berlin.
authors.forename: B
authors.initials: B
authors.lastname: Bratzke
authors.forename: R
authors.initials: R
authors.lastname: Stadler
authors.forename: H
authors.initials: H
authors.lastname: Gollnick
authors.forename: A
authors.initials: A
authors.lastname: Rolfs
authors.forename: G
authors.initials: G
authors.lastname: Höffken
authors.forename: V
authors.initials: V
authors.lastname: Preac-Mursic
authors.forename: B
authors.initials: B
authors.lastname: Wilske
authors.forename: F
authors.initials: F
authors.lastname: Schaart
authors.forename: C E
authors.initials: CE
authors.lastname: Orfanos
mesh_terms: D001431:Bacteriological Techniques; D001706:Biopsy; D015748:Borrelia burgdorferi Group / Q000254:growth & development*; D015787:Erythema Chronicum Migrans / Q000382:microbiology / Q000473:pathology*; D005455:Fluorescent Antibody Technique; D006679:HIV Seropositivity / Q000473:pathology*; D015497:HIV-1 / Q000472:pathogenicity*; D006801:Humans; D007801:Langerhans Cells / Q000473:pathology; D008223:Lymphoma / Q000382:microbiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000382:microbiology / Q000473:pathology*; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000382:microbiology / Q000473:pathology*
vernacular_title: Borrelia-burgdorferi-induziertes Pseudolymphom mit Erregeranzüchtung bei einem HIV-1-positiven Kranken.