Open AccessCharacteristics of spirochetemic patients with a solitary erythema migrans skin lesion in Europe
Author(s) -
Vera Maraspin,
Katarina Ogrinc,
Tereza Rojko,
Petra Bogovič,
Eva RužićSabljić,
Andrej Kastrin,
Gary P. Wormser,
Franc Strle
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0250198
Subject(s) - borrelia afzelii , erythema migrans , borrelia garinii , borrelia , lesion , medicine , dermatology , erythema chronicum migrans , lyme disease , pathology , borrelia burgdorferi , immunology , antibody , lyme borreliosis
Neither pre-treatment characteristics, nor the outcome after antibiotic therapy, have been reported for spirochetemic European patients with Lyme borreliosis. In the present study, patients with a solitary erythema migrans (EM) who had a positive blood culture for either Borrelia afzelii (n = 116) or Borrelia garinii (n = 37) were compared with age- and sex-matched patients who had a negative blood culture, but were culture positive for the corresponding Borrelia species from skin. Collectively, spirochetemic patients significantly more often recalled a tick bite at the site of the EM skin lesion, had a shorter time interval from the bite to the onset of EM, had a shorter duration of the skin lesion prior to diagnosis, and had a smaller EM skin lesion that was more often homogeneous in appearance. Similar results were found for the subset of spirochetemic patients infected with B . afzelii but not for those infected with B . garinii . However, patients with B . garinii bacteremia had faster-spreading and larger EM skin lesions, and more often reported itching at the site of the lesion than patients with B . afzelii bacteremia. Treatment failures were rare (7/306 patients, 2.3%) and were not associated with having spirochetemia or with which Borrelia species was causing the infection.