Recurrent erythema migrans despite extended antibiotic treatment with minocycline in a patient with persisting Borrelia burgdorferi infection

J Am Acad Dermatol. 1993 Feb;28(2 Pt 2):312-4. doi: 10.1016/0190-9622(93)70043-s.


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.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Erythema Chronicum Migrans / drug therapy*
  • Erythema Chronicum Migrans / pathology
  • Female
  • Humans
  • Lyme Disease
  • Minocycline / therapeutic use*
  • Recurrence
  • Tetracycline / therapeutic use


  • Tetracycline
  • Minocycline