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Volume 25, Number 10—October 2019
Dispatch

Two Cases of Borrelia miyamotoi Meningitis, Sweden, 2018

Anna J. HenningssonComments to Author , Hilmir Asgeirsson, Berit Hammas, Elias Karlsson, Åsa Parke, Dieuwertje Hoornstra, Peter Wilhelmsson, and Joppe W. Hovius
Author affiliations: Linköping University, Linköping, Sweden (A.J. Henningsson, P. Wilhelmsson); County Hospital Ryhov, Jönköping, Sweden (A.J. Henningsson, P. Wilhelmsson); Karolinska Institutet, Stockholm, Sweden (H. Asgeirsson); Karolinska University Hospital, Stockholm (H. Asgeirsson, B. Hammas, Å. Parke); Danderyd University Hospital, Stockholm (E. Karlsson); Academic Medical Center, Amsterdam, the Netherlands (D. Hoornstra, J.W. Hovius)

Main Article

Table

Confirmatory analyses performed on cerebrospinal fluid and serum/plasma samples from 2 patients with diagnoses of meningitis caused by Borrelia miyamotoi, Sweden, 2018*

Analysis
Patient A, dates samples collected

Patient B, dates samples collected
Jul 30
Aug 6
Aug 24
Aug 9
Oct 31
Sample Serum CSF Serum CSF Serum Serum Plasma CSF Serum
BM-specific PCR

+

+
+

NA

NA
+
+

NA
BM-specific serologic testing
IgM+ (GlpQ, Vlp5), IgG–
NA

IgM+ (GlpQ, Vlp5), IgG+ (GlpQ)
NA

IgM+ (GlpQ, Vsp1), IgG+ (GlpQ, Vlp15/16)

IgM+ (GlpQ), IgG–
NA
NA

IgM+ (GlpQ), IgG–
LB serology†




IgM AI+

–‡


NA
IgM detectable, but AI–

–‡
Culture attempts NA NA NA NA

*Patient A: a 53-year-old immunocompetent woman; patient B: a 66-year-old immunocompromised woman. AI, antibody index; BM, Borrelia miyamotoi; CSF, cerebrospinal fluid; GlpQ, glycerophosphodiester-phosphodiesterase; LB, Lyme borreliosis; NA, not analyzed; Vlp, variable large protein; Vsp, variable small protein; +, positive; –, negative.
†LIAISON Borrelia burgdorferi (DiaSorin, https://www.diasorin.com).
‡In addition to LIAISON, the sample was analyzed by Enzygnost Lyme link VlsE IgG and Enzygnost Borreliosis IgM (DADE Behring, https://www.siemens.com), recomBead Borrelia IgM and IgG (Mikrogen GmbH, https://www.mikrogen.de), C6 Lyme ELISA Kit (Immunetics, https://immunetics.com), and Anti-Borrelia EUROLINE-RN-AT IgG and IgM (EUROIMMUN, http://www.euroimmun.com). All test results were negative.

Main Article

Page created: September 17, 2019
Page updated: September 17, 2019
Page reviewed: September 17, 2019
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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