Borrelia

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 15.03.2021

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Synonym(s)

Borrelia burgdorferi

Definition
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Gram-negative, irregular, spiral-shaped bacteria from the Spirochaetaceae family. They are named after the French bacteriologist Amédée Borrel.

Pathogen
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Of medical importance are among others the species:

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Occurrence/Epidemiology
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Borrelia burgdorferi sensu lato is transmitted by the bite of infected ticks and is detectable in about 5-35% of the ticks in Germany depending on the area (e.g. in Southern Lower Saxony in spring 2007 in 25% of the ticks examined). Rodents and birds serve as pathogen reservoirs.

Geographical distribution of common Borrelia spp.
pathogen Geographical distribution Vector
B. sensu strictu Europe, USA Ticks
B. garinii Europe, Asia Ticks
B. afzelii Europe, Asia Ticks
B. lusitaniae Europe, Asia Ticks
B. valaisiana Europe, Asia Ticks
B. andersonii USA Ticks
B. japonica Japan Ticks
B. recurrentis North Africa, more rarely in Asia and South America Lice, ticks, rarely transmission by blood transfusion
B. duttonii Africa, Saudi Arabia, Iran, India, Central Asia, occasionally America and Southern Europe Lice

Diagnosis
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Determination of IgM/IgG antibodies against Borrelia using ELISA, IFT (indirect immunofluorescence test), in case of detection of anti-Borrelia antibodies additionally Western blot.

Antigen detection by PCR (blood, joint puncture, cerebrospinal fluid, skin biopsy, urine).

Pathogen detection from culture cultivation.

Note(s)
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Ixodes ricinus can transmit other pathogens to humans besides Borrelia:

  • TBE virus-a flavivirus, pathogen of early summer meningoencephaltitis
  • Babesia, protozoa parasitizing in erythrocytes, the causative agent of babesiosis, a malaria-like disease
  • Anaplasma phagocytophilum, an intracellular Gram-negative bacterium of the genus Rickettsiales, pathogen of human granulocytic anaplasmosis(Ehrlichiosis)
  • B. miyamotoi, pathogen of relapsing fever.

The patterns of anti-Borrelia antibodies observed in infected humans show a high degree of variability. A number of important immunodominant Borrelia proteins could be assigned to the clinical stages of the disease (see also Borrelia antigen structure).

  • Early stage: the IgM antibody response is directed against the outer membrane protein C (Osp C = 0uter surface protein C) and/or flagellin protein (FlaB: cross-reaction with spirochetes and flagellated bacteria).
  • As the Borrelia infection progresses, other proteins are included in the immune response. A chromosomally encoded Borrelia protein p100 (synonym: p94 / p83) is found as a marker for the late stage of Lyme disease, as is OspA. It is generally accepted that in clinical routine an antigen mixture instead of purified single Borrelia antigens is useful. The antigen mixture should contain proteins like Osp C, BmpA (Borrelia membrane antigen = p39 antigen), p41 antigen and p100 antigen.
  • A number of conserved Borrelia proteins, such as heat shock proteins and parts of flagellin have epitopes that are also found on other bacteria (this leads to false positive results).

Literature
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  1. Baumgarten JM et al (2002) Lyme disease--part I: epidemiology and etiology. Cutis 69: 349-352
  2. Brandt FC (2015) Genotyping of Borrelia on paraffin-embedded skin biopsies of cutaneous Lyme disease by IGS, ospA and OspC PCR. JDDG 13 (Suppl 1):156

  3. Burgdorfer W et al (1982) Lyme disease - a tick borne spirochetosis? Science 216: 1317-1319
  4. Montiel NJ et al (2002) Lyme disease--part II: clinical features and treatment.cutis 69: 443-448
  5. Donovan BJ (2002) Treatment of tick-borne diseases. Ann Pharmacother 36: 1590-1597
  6. Gissler S, Heininger U (2002) Borrelia lymphocytoma ("lymphadenosis benigna cutis"). Arch Dis Child 87: 12
  7. Grange F (2002) Borrelia burgdorferi-associated lymphocytoma cutis simulating a primary cutaneous large B-cell lymphoma. J Am Acad Dermatol 47: 530-534
  8. Hengge UR et al (2003) Lyme borreliosis. Lancet Infect Dis 3: 489-500
  9. Nadelman RB (1998) Lyme borreliosis. Lancet 352: 558-565
  10. Steere AC (2001) Lyme disease. N Engl J Med 345: 115-125

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Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 15.03.2021