Are differences in presentation of early Lyme borreliosis in Europe and North America a consequence of a more frequent spirochetemia in American patients?

Maraspin-Čarman, Vera (author), Bogovič, Petra (author), Ogrinc, Katarina (author), Rojko, Tereza (author), Ružić-Sabljić, Eva (author), Kastrin, Andrej (author), Strle, Klemen (author), Wormser, Gary P. (author), Strle, Franc (author)

To assess whether differences in presentation between US and European patients with early Lyme borreliosis are due to the lower rate of spirochetemia in Europe, we compared multiple variables for patients with erythema migrans (EM), restricting the analysis to subjects with a positive blood culture at the time of presentation: 93 US patients infected with Borrelia burgdorferi versus 183 European patients infected with Borrelia afzelii (No = 144) or Borrelia garinii (No = 39). Compared to spirochetemic Slovenian EM patients infected with B. afzelii, US patients with a positive blood culture significantly less often recalled a preceding tick bite at the site of the EM skin lesion, had a shorter duration of EM prior to diagnosis and more often had multiple EM lesions, regional lymphadenopathy, constitutional symptoms, an increased ESR value, a low blood lymphocyte count and detectable borrelia antibodies in acute and convalescent phase blood samples. Similar differences were observed when US patients were compared to Slovenian patients with B. garinii infection, but not all reached statistical significance. The findings are comparable to those previously reported for the corresponding skin culture positive patients and do not support the hypothesis that a higher frequency of spirochetemia at the time of presentation in US patients with EM, compared with European EM patients, is the reason for the observed differences.

• Language: English
• Keywords: Borrelia burgdorferi, Borrelia afzelii, Borrelia garinii, Lyme borreliosis, isolation, blood, USA, Europe
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2021
• Number of pages: 8 str.
• Numbering: Vol. 10, iss. 7, art. 1448
• PID: 20.500.12556/RUL-135362
• UDC: 616.9
• ISSN on article: 2077-0383
• DOI: 10.3390/jcm10071448
• COBISS.SI-ID: 59069699
• Publication date in RUL: 09.03.2022

Record is a part of a journal

• Title: Journal of clinical medicine
• Shortened title: J. clin. med.
• Publisher: MDPI
• ISSN: 2077-0383
• COBISS.SI-ID: 5405759

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.
• Licensing start date: 01.04.2021

Secondary language

• Language: Slovenian
• Keywords: Borrelia burgdorferi, Borrelia afzelii, Borrelia garinii, lymska borelioza, izolacija, kri, ZDA, Evropa

Projects

• Funder: ARRS - Slovenian Research Agency
• Project number: P3-0296
• Name: Bolezni in povzročitelji, ki jih v Sloveniji prenašajo členonožci