title: Cultivation of Borrelia burgdorferi from the blood of two patients with erythema migrans lesions lacking extracutaneous signs and symptoms of Lyme disease.
abstract: BACKGROUND
  We recently demonstrated that cultivation of Borrelia burgdorferi from skin biopsy specimens obtained from erythema migrans lesions was an efficacious procedure to confirm the diagnosis of Lyme disease.
  
  
  OBJECTIVE
  Our purpose was to investigate the efficacy of our microbiologic technique on blood samples obtained from patients with Lyme disease and erythema migrans.
  
  
  METHODS
  Whole blood samples were obtained from 52 patients with erythema migrans and early localized or early disseminated Lyme disease and placed into polystyrene tubes containing 6 ml of modified Barbour-Stoenner-Kelly medium, processed, and examined for B. burgdorferi by dark-field microscopy.
  
  
  RESULTS
  B. burgdorferi was cultured from the blood of two of our 52 patients (4%). Clinically, both of these patients were considered to have early localized Lyme disease.
  
  
  CONCLUSIONS
  The culture of B. burgdorferi from the blood of patients with early Lyme disease does not appear to be an efficacious procedure to confirm the diagnosis of Lyme disease. However, the demonstration of spirochetemia in patients with erythema migrans without any extracutaneous evidence of disseminated illness does have therapeutic significance.
authors.affiliation: Department of Dermatology, State University of New York at Stony Brook.
authors.forename: B W
authors.initials: BW
authors.lastname: Berger
authors.forename: R C
authors.initials: RC
authors.lastname: Johnson
authors.forename: C
authors.initials: C
authors.lastname: Kodner
authors.forename: L
authors.initials: L
authors.lastname: Coleman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015748:Borrelia burgdorferi Group / Q000254:growth & development* / Q000302:isolation & purification; D015787:Erythema Chronicum Migrans / Q000382:microbiology*; D005260:Female; D006801:Humans; D008193:Lyme Disease / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012698:Serologic Tests