Electron microscopy and the polymerase chain reaction of spirochetes from the blood of patients with Lyme disease.

 Cent Eur J Public Health. 1993 Dec;1,2:81-5. Electron microscopy and the polymerase chain 
reaction of spirochetes from the blood of patients with Lyme disease. Hulínská D, Krausová M, 
Janovská D, Rohácová H, Hancil J, Mailer H.
Department of Electron Microscopy, National Institute of Public Health, Prague, Czech Republic.
Results of studies using direct antigen detection suggest that seronegative Lyme borreliosis is 
not rare and support the hypothesis that Borrelia antigens can persist in humans. We report 
three successful cultures from blood out of 30 attempts from 96 Lyme disease patients. The 
proof of borreliaemia in early or late phases of Lyme disease by immuno-capture electron 
microscopy has practical importance for subsequent cultivation. The polymerase chain reaction 
with oligonucleotide sequences directed against 16S rRNA identified two of our blood isolates as 
Borrelia burgdorferi genospecies III., VS 461 group, and one as Borrelia garinii sp. nov. All of the 
three isolates were reactive with monoclonal antibody H9724 against flagellin and with antibody 
against main extracellular protein at 83 kDa. Borrelia garinii had a single predominant protein 
OspA at 33.5 kDa and reacted with monoclonal antibody H5332 in contrast to two isolates of the 
VS 461 group with two major proteins OspA and OspB at 32.5 and 35 kDa. We conclude that 
isolation of spirochetes from the blood might prove successful in clinically selected cases of 
Lyme borreliosis. Immuno-capture electron microscopy has proved to be a sensitive assay for 
monitoring and studying Lyme borreliosis.Clin Orthop Relat Res. 1993 Dec;,297:238-41. Chronic 
septic arthritis caused by Borrelia burgdorferi. Battafarano DF, Combs JA, Enzenauer RJ, 
Fitzpatrick JE.
Department of Medicine, Fitzsimons Army Medical Center, Aurora, Colorado 80045-5001.
Chronic arthritis occurs in 10% of Lyme disease patients. A patient had chronic septic Lyme 
31arthritis of the knee for seven years despite multiple antibiotic trials and multiple 
arthroscopic and open synovectomies. Spirochetes were documented in synovium and 
synovial fluid, SF. Polymerase chain reaction, PCR, analysis of the SF was consistent with 
Borrelia infection. Persistent infection should be excluded with silver stains and cultures in any 
patient with chronic monoarticular arthritis and a history of Lyme disease

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