Nodular fasciitis, erythema migrans, and oligoarthritis: manifestations of Lyme borreliosis caused by Borrelia afzelii.
We describe a 35-year old patient with nodular fasciitis, erythema migrans, and gonarthritis four months after a bite of a Borrelia afzelii infected tick. The Borrelia afzelii infection was identified by a polymerase chain reaction and direct sequencing of the amplification product. Borrelia-specific DNA was also detectable in nodular fasciitis tissue. We therefore conclude that Borrelia afzelii can be a causative agent of nodular fasciitis and Lyme arthritis in a highly endemic region of Northern Germany.
Division of Rheumatology, Hannover Medical School, Hannover, Germany. schnarr.sebastian@mh-hannover.de
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S
Schnarr
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A
Wahl
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B
Jürgens-Saathoff
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M
Mengel
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HH
Kreipe
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H
Zeidler
D000328:Adult; D001170:Arthritis, Infectious / Q000209:etiology*; D015748:Borrelia burgdorferi Group; D015787:Erythema Chronicum Migrans / Q000209:etiology*; D005208:Fasciitis / Q000209:etiology*; D006801:Humans; D008193:Lyme Disease / Q000150:complications*; D008297:Male