Culture-Confirmed Infection and Reinfection with Borrelia burgdorferi
Authors: John Nowakowski
Journal: Annals of Internal Medicine (1997)

Brief Communications15 July 1997Culture-Confirmed Infection and Reinfection with Borrelia burgdorferiJohn Nowakowski, MD, Ira Schwartz, PhD, Robert B. Nadelman, MD, Dionysios Liveris, PhD, Maria Aguero-Rosenfeld, MD, and Gary P. Wormser, MDJohn Nowakowski, MDFrom New York Medical College and the Lyme Disease Diagnostic Center, Westchester County Medical Center, Valhalla, New York., Ira Schwartz, PhDFrom New York Medical College and the Lyme Disease Diagnostic Center, Westchester County Medical Center, Valhalla, New York., Robert B. Nadelman, MDFrom New York Medical College and the Lyme Disease Diagnostic Center, Westchester County Medical Center, Valhalla, New York., Dionysios Liveris, PhDFrom New York Medical College and the Lyme Disease Diagnostic Center, Westchester County Medical Center, Valhalla, New York., Maria Aguero-Rosenfeld, MDFrom New York Medical College and the Lyme Disease Diagnostic Center, Westchester County Medical Center, Valhalla, New York., and Gary P. Wormser, MDFrom New York Medical College and the Lyme Disease Diagnostic Center, Westchester County Medical Center, Valhalla, New York.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-2-199707150-00006 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Lyme disease, the most common vector-borne disease in the United States, is caused by infection with the spirochete Borrelia burgdorferi[1]. Reinfection has been described clinically but has not been substantiated microbiologically [2-5]. We documented the occurrence of reinfection by isolating B. burgdorferi during two different clinical episodes of Lyme disease. Polymerase chain reaction (PCR)-restriction fragment length polymorphism analysis of the two isolates showed that the isolates were different strains of B. burgdorferi, suggesting reinfection and not reactivation of a previous infection. We also used enzyme-linked immunosorbent assay (ELISA) and immunoblot to evaluate the antibody response of sequential blood samples to ...References1. Steere AC. Lyme disease. N Engl J Med. 1989; 321:586-96. Google Scholar2. Hollstrom E. Penicillin treatment of erythema chronicum migrans Afzelius. Acta Derm Vener. 1958; 38:285-9. Google Scholar3. Weber K, Schierz G, Wilske B, Neubert U, Krampitz HE, Barbour AG, et al. Reinfection in erythema migrans disease. Infection. 1986; 14:32-5. Google Scholar4. Pfister HW, Neubert U, Wilske B, Preac-Mursic V, Einhaupl KM, Borasio GD. Reinfection with Borrelia burgdorferi [Letter]. Lancet 1986; 2:984-5. Google Scholar5. Hassler D, Maiwald M. [Reinfection with Borrelia burgdorferi in an immunocompetent patient]. Dtsch Med Wochenschr. 1994; 119:338-42. Google Scholar6. Schwartz I, Wormser GP, Schwartz JJ, Cooper D, Weissensee P, Gazumyan A, et al. Diagnosis of early Lyme disease by polymerase chain reaction amplification and culture of skin biopsies from erythema migrans lesions. J Clin Microbiol. 1992; 30:3082-8. Google Scholar7. Liveris D, Gazumyan A, Schwartz I. Molecular typing of Borrelia burgdorferi sensu lato by PCR-restriction fragment length polymorphism analysis. J Clin Microbiol. 1995; 33:589-95. Google Scholar8. Liveris D, Wormser GP, Nowakowski J, Nadelman R, Bittker S, Cooper D, et al. Molecular typing of Borrelia burgdorferi from Lyme disease patients by PCR-restriction fragment length polymorphism analysis. J Clin Microbiol. 1996; 34:1306-9. Google Scholar9. Recommendations for test performance and interpretation from the Second National Conference on Serologic Diagnosis of Lyme Disease. MMWR Morb Mortal Wkly Rep. 1995; 44:590-1. Google Scholar Author, Article, and Disclosure InformationAffiliations: From New York Medical College and the Lyme Disease Diagnostic Center, Westchester County Medical Center, Valhalla, New York.Acknowledgments: The authors thank Susan Bittker, Denise Cooper, Charles Pavia, Gilda Forseter, Diane Holmgren, Donna McKenna, Harold Horowitz, Marisa Montecalvo, and Neil Rosenfeld for their assistance.Grant Support: In part by Cooperative Agreement no. U50/CCU 210280 from the Centers for Disease Control and Prevention and by grants AR41508 and AR41511 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. The contents of this report are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the National Institute of Arthritis and Musculoskeletal and Skin Diseases.Corresponding Author: John Nowakowski, MD, Division of Infectious Diseases, Department of Medicine, New York Medical College, Macy Pavilion 209SE, Valhalla, NY 10595.Current Author Addresses: Drs. Nowakowski, Nadelman, and Wormser: Division of Infectious Diseases, Department of Medicine, New York Medical College, Macy Pavilion 209SE, Valhalla, NY 10595. 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Smith, MD, MPH, Robert T. Schoen, MD, Daniel W. Rahn, MD, Vijay K. Sikand, MD, John Nowakowski, MD, Dennis L. Parenti, MD, Mary S. Holman, BA, David H. Persing, MD, PhD, and Allen C. Steere, MDErythema migransLyme Vaccine: Issues and ControversiesLyme borreliosisCulture-Confirmed Reinfection of a Person with Different Strains of Borrelia burgdorferi Sensu Stricto 15 July 1997Volume 127, Issue 2Page: 130-132KeywordsBiopsyBorrelia burgdorferiEnzyme linked immunosorbent assayErythemaLesionsLyme diseasePolymerase chain reactionRashesRestriction fragment length polymorphism analysisSpirochetes Issue Published: 15 July 1997 CopyrightCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...