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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
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Page updated: August 16, 2016
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