title: Isolation of Borrelia burgdorferi sensu lato from blood of patients with erythema migrans.
abstract: BACKGROUND
  We assessed the isolation rate of Borrelia burgdorferi sensu lato from blood in European patients with typical erythema migrans and evaluated the course and outcome of their illness.
  
  
  METHODS
  Adult patients diagnosed with erythema migrans and from whom borreliae cultured from blood were included in this study.
  
  
  RESULTS
  Borreliae were isolated from the blood of 35/2,828 (1.2%) patients, on average 7 days (range 1-47 days) after the appearance of erythema migrans. Only seven (20%) patients reported constitutional symptoms. 24/35 isolates were typed of which 20 were Borrelia afzelii and four were Borrelia garinii. 31 (88.6%) patients were treated with oral antibiotics while four (11.4%) received ceftriaxone iv. The course and outcome of the illness were favorable in all patients.
  
  
  CONCLUSIONS
  In European patients with erythema migrans the yield of blood culturing was low, spirochetemia was often clinically silent and the course and outcome of the illness were favorable; the predominantly isolated strain was B. afzelii.
authors.affiliation: University Medical Centre Ljubljana, Dept of Infectious Diseases, Slovenia. vera.maraspin@kclj.si
authors.forename: V
authors.initials: V
authors.lastname: Maraspin
authors.forename: E
authors.initials: E
authors.lastname: Ruzić-Sabljić
authors.forename: J
authors.initials: J
authors.lastname: Cimperman
authors.forename: S
authors.initials: S
authors.lastname: Lotric-Furlan
authors.forename: T
authors.initials: T
authors.lastname: Jurca
authors.forename: R N
authors.initials: RN
authors.lastname: Picken
authors.forename: F
authors.initials: F
authors.lastname: Strle
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015748:Borrelia burgdorferi Group / Q000302:isolation & purification* / Q000472:pathogenicity; D002443:Ceftriaxone / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D004890:Erythema / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D005260:Female; D006801:Humans; D008193:Lyme Disease / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D002443:Ceftriaxone