title: Isolation of Borrelia burgdorferi from biopsy specimens taken from healthy-looking skin of patients with Lyme borreliosis.
abstract: Erythematous skin lesions due to infection with Borrelia burgdorferi will often disappear without antibiotic treatment. The aim of the study was to assess whether after disappearance of the erythematous skin lesion B. burgdorferi is still present in the healthy-looking skin of untreated patients. In six patients, a skin biopsy specimen was taken at the site of a previous erythematous skin lesion 1 to 6 months after disappearance of the lesion. Four of them presented with early disseminated Lyme borreliosis. In one additional patient with early disseminated Lyme borreliosis, the site of a previous tick bite was biopsied. None of these patients had been treated with antibiotics before presentation. The cultures of the skin biopsy specimens of the seven patients showed growth of Borrelia species. By rRNA gene restriction analysis and genospecies-specific PCR, six isolates were classified as Borrelia garinii and one as Borrelia group VS461. These results show that B. burgdorferi can still be cultured from the skin after disappearance of the erythematous skin lesion or at the site of a previous tick bite.
authors.affiliation: Department of Medical Microbiology, Academic Medical Centre, University Hospital, University of Amsterdam, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Kuiper
authors.forename: A P
authors.initials: AP
authors.lastname: van Dam
authors.forename: L
authors.initials: L
authors.lastname: Spanjaard
authors.forename: B M
authors.initials: BM
authors.lastname: de Jongh
authors.forename: A
authors.initials: A
authors.lastname: Widjojokusumo
authors.forename: T C
authors.initials: TC
authors.lastname: Ramselaar
authors.forename: I
authors.initials: I
authors.lastname: Cairo
authors.forename: K
authors.initials: K
authors.lastname: Vos
authors.forename: J
authors.initials: J
authors.lastname: Dankert
mesh_terms: D000293:Adolescent; D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood / Q000134:cerebrospinal fluid; D001483:Base Sequence; D015748:Borrelia burgdorferi Group / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D002648:Child; D017931:DNA Primers / Q000235:genetics; D004269:DNA, Bacterial / Q000235:genetics; D004275:DNA, Ribosomal / Q000235:genetics; D015787:Erythema Chronicum Migrans / Q000382:microbiology; D005260:Female; D006801:Humans; D008193:Lyme Disease / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D012867:Skin / Q000382:microbiology*; D013997:Time Factors
chemical_list: D000907:Antibodies, Bacterial; D017931:DNA Primers; D004269:DNA, Bacterial; D004275:DNA, Ribosomal