Isolation of Borrelia burgdorferi sensu lato from blood of patients with erythema migrans

Infection. Mar-Apr 2001;29(2):65-70. doi: 10.1007/s15010-001-0154-6.


Background: We assessed the isolation rate of Borrelia burgdorferi sensu lato from blood in European patients with typical erythema migrans and evaluated the course and outcome of their illness.

Patients and methods: Adult patients diagnosed with erythema migrans and from whom borreliae cultured from blood were included in this study.

Results: Borreliae were isolated from the blood of 35/2,828 (1.2%) patients, on average 7 days (range 1-47 days) after the appearance of erythema migrans. Only seven (20%) patients reported constitutional symptoms. 24/35 isolates were typed of which 20 were Borrelia afzelii and four were Borrelia garinii. 31 (88.6%) patients were treated with oral antibiotics while four (11.4%) received ceftriaxone iv. The course and outcome of the illness were favorable in all patients.

Conclusion: In European patients with erythema migrans the yield of blood culturing was low, spirochetemia was often clinically silent and the course and outcome of the illness were favorable; the predominantly isolated strain was B. afzelii.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Borrelia burgdorferi Group / isolation & purification*
  • Borrelia burgdorferi Group / pathogenicity
  • Ceftriaxone / therapeutic use
  • Cephalosporins / therapeutic use
  • Erythema / drug therapy
  • Erythema / etiology
  • Erythema / microbiology*
  • Female
  • Humans
  • Lyme Disease / drug therapy
  • Lyme Disease / etiology
  • Lyme Disease / microbiology*
  • Male
  • Middle Aged
  • Prognosis
  • Treatment Outcome


  • Anti-Bacterial Agents
  • Cephalosporins
  • Ceftriaxone