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Volume 22, Number 9—September 2016
Dispatch

Borrelia miyamotoi–Associated Neuroborreliosis in Immunocompromised Person

Katharina BodenComments to Author , Sabine Lobenstein, Beate Hermann, Gabriele Margos, and Volker Fingerle
Author affiliations: University Hospital Jena, Jena, Germany (K. Boden, B. Hermann); Burgenlandkreis Hospital Naumburg, Naumburg, Germany (S. Lobenstein); Bavarian Health and Food Safety Authority, Oberschleissheim, Germany (G. Margos, V. Fingerie)

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Table

CSF findings of Borrelia miyamotoi meningitis cases and patients with Lyme neuroborrelioses*

Finding (reference) Case (reference)
New Jersey, USA (4) Netherlands (5) Germany (this study) Lyme neuroborreliosis(6)†
Leukocytes/μL (0–5 cells/μL) 65 388 70 170.5 [57.0–369]
Differential count 23% PMNC, 70% lymphocytes, 6% monocytes, 1% diverse 60% mononuclear cells 32% PMNC, 61% lymphocytes, 7% monocytes
Protein level, mg/dL (150–400 mg/dL) >300 486 1718 1,232 [697–1,926]
Qalb, × 103 (<9) 34.8 17.2 [9.7–28.4]
Quantitative IgM, × 103 18.1 Elevated in 70%
Glucose, mmol/L (2.2–4.2 mmol/L) 1.8 1.6 2.41
Glucose ratio (>0.5) 0.45
Lactate, mmol/L (1.2–2.1 mmol/L) 5.58 >3.5 in 4%‡
Routine microscopy Cellular CSF with high nos. of granulocytes and plasma cells Cellular CSF with heterogeneous morphology
CXCL13, pg/mL (100 to <250 pg/mL, borderline) 1,150; 8 d after start of therapy: 186 >415 (7)
Spirochetes visible in CSF by Gram staining, Giemsa staining Darkfield microscopy Acridinorange staining, not definable at Pappenheim cytospin Typically negative

*Blank cells indicate value not determined or was within reference range. CSF, cerebrospinal fluid; PMNC, polymorphonuclear leukocytes; Qalb, albumin quotient.
†n = 118 patients. Values are median [interquartile range].
‡Associated with headache.

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References
  1. Platonov  AE, Karan  LS, Kolyasnikova  NM, Makhneva  NA, Toporkova  MG, Maleev  VV, Humans infected with relapsing fever spirochete Borrelia miyamotoi, Russia. Emerg Infect Dis. 2011;17:181623. DOIPubMed
  2. Krause  PJ, Fish  D, Narasimhan  S, Barbour  AG. Borrelia miyamotoi infection in nature and in humans. Clin Microbiol Infect. 2015;21:6319. DOIPubMed
  3. Telford  SR III, Goethert  HK, Molloy  PJ, Berardi  VP, Chowdri  HR, Gugliotta  JL, Borrelia miyamotoi disease: neither Lyme disease nor relapsing fever. Clin Lab Med. 2015;35:86782. DOIPubMed
  4. Gugliotta  JL, Goethert  HK, Berardi  VP, Telford  SR III. Meningoencephalitis from Borrelia miyamotoi in an immunocompromised patient. N Engl J Med. 2013;368:2405. DOIPubMed
  5. Hovius  JW, de Wever  B, Sohne  M, Brouwer  MC, Coumou  J, Wagemakers  A, A case of meningoencephalitis by the relapsing fever spirochaete Borrelia miyamotoi in Europe. Lancet. 2013;382:658. DOIPubMed
  6. Djukic  M, Schmidt-Samoa  C, Lange  P, Spreer  A, Neubieser  K, Eiffert  H, Cerebrospinal fluid findings in adults with acute Lyme neuroborreliosis. J Neurol. 2012;259:6306. DOIPubMed
  7. Hytönen  J, Kortela  E, Waris  M, Puustinen  J, Salo  J, Oksi  J. CXCL13 and neopterin concentrations in cerebrospinal fluid of patients with Lyme neuroborreliosis and other diseases that cause neuroinflammation. J Neuroinflammation. 2014;11:103. DOIPubMed
  8. Tsutsumi  Y, Yamamoto  Y, Ito  S, Ohigashi  H, Shiratori  S, Naruse  H, Hepatitis B virus reactivation with a rituximab-containing regimen. World J Hepatol. 2015;7:234451. DOIPubMed
  9. Nei  M, Kumar  S. Molecular evolution and phylogenetics. New York: Oxford University Press; 2000.
  10. Tamura  K, Peterson  D, Peterson  N, Stecher  G, Nei  M, Kumar  S. MEGA5: Molecular Evolutionary Genetics Analysis using maximum likelihood, evolutionary distance, and maximum parsimony methods. Mol Biol Evol. 2011;28:27319. DOIPubMed

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Page updated: August 16, 2016
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