DNA Sequencing Diagnosis of Off-Season Spirochetemia with Low Bacterial Density in Borrelia burgdorferi andBorrelia miyamotoi Infections

Commentary: Dr SH Lee, Dr Tom Moorcroft and Dr Katherine Lantsman published a paper in the International Journal of Molecular Sciences which showed the presence of borrelia in the blood of ambulatory patients during the winter months when the likelihood of a new bite and infection is rare. The authors found evidence of both Lyme disease and the relapsing fever spirochete Borrelia miyamotoi by PCR in the blood of patients. This scientific report illustrates the usefulness of a sensitive PCR assay in detecting spirochetal infections that may go undetected by other methodologies, and highlights the fact that other borrelia species such as B. miyamotoi are rapidly spreading, and may be associated with a persistent infection with Lyme disease. I have found that multiple tick-borne co-infections are the rule and not the exception in the Lyme-MSIDS patients who come to see me.

“With this newly developed method, we found 14 ambulatory patients with spirochetemia containing 25–50 borrelial cells per mL of whole blood in a month of deep winter inthe Northeast of the U.S.A. when tick activity in the region was minimal. We conclude that these patients represented undiagnosed cases of “Lyme and related borreliosis” or persistent infection of“Lyme and related borreliosis” after standard antibiotic treatments failed to eradicate the causative agents from the infected tissues. A sensitive and reliable laboratory test for the infectious agents of “Lyme and related borreliosis” should be available in the hospital laboratories located in the disease-endemic communities to diagnose these cases for timely and appropriate treatment”.

DNA Sequencing Diagnosis of Off-Season Spirochetemia with Low Bacterial Density in Borrelia burgdorferi andBorrelia miyamotoi Infections, International Journal of Molecular Sciences