Recurrent erythema migrans despite extended antibiotic treatment with minocycline in a patient with persisting Borrelia burgdorferi infection.
Erythema migrans recurred in a patient 6 months after a course of treatment with minocycline for Lyme disease. Polymerase chain reaction on heparinized peripheral blood at that time demonstrated the presence of Borrelia burgdorferi-specific DNA. The patient was seronegative by Lyme enzyme-linked immunosorbent assay but showed suspicious bands on Western blot. Findings of a Warthin-Starry stain of a skin biopsy specimen of the eruption revealed a Borrelia-compatible structure. Reinfection was not believed to have occurred. Further treatment with minocycline led to resolution of the erythema migrans.
Liegner
K B
KB
Department of Medicine, Northern Westchester Hospital Center, Mount Kisco, NY.
Shapiro
J R
JR
Ramsay
D
D
Halperin
A J
AJ
Hogrefe
W
W
Kong
L
L
D000368:Aged; D015787:Erythema Chronicum Migrans / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D008193:Lyme Disease; D008911:Minocycline / Q000627:therapeutic use*; D012008:Recurrence; D013752:Tetracycline / Q000627:therapeutic use
D013752:Tetracycline; D008911:Minocycline