Recurrent erythema migrans despite extended antibiotic treatment with minocycline in a patient with persisting Borrelia burgdorferi infection
Liegner KB, Shapiro JR, Ramsay D +3 more1993Journal of the American Academy of DermatologyJournal Article
DermatologicalImmune/InnateNeurological
Lyme & Co-Infections
Abstract
Erythema migrans recurred in a patient 6 months after a course of treatment with minocycline for Lyme disease. Polymerase chain reaction on heparinized peripheral blood at that time demonstrated the presence of Borrelia burgdorferi-specific DNA. The patient was seronegative by Lyme enzyme-linked immunosorbent assay but showed suspicious bands on Western blot. Findings of a Warthin-Starry stain of a skin biopsy specimen of the eruption revealed a Borrelia-compatible structure. Reinfection was not believed to have occurred. Further treatment with minocycline led to resolution of the erythema migrans.
Key Biomarkers
Borrelia burgdorferiErythema migransIgG antibodiesIgM antibodies
Symptom Clusters
DepressionLyme encephalopathyMemory impairmentPersistent infection despite antibiotic treatmentRecurrent erythema migrans
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