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Infection with multiple strains of Borrelia burgdorferi sensu stricto in patients with Lyme disease.

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Abstract

OBJECTIVE:

To assess human skin biopsy specimens from erythema migrans lesions for the presence of infection with multiple strains of the
Lyme disease spirochete, Borrelia burgdorferi.

DESIGN:

Skin biopsy specimens were obtained prospectively from patients with erythema migrans. To determine allelic differences and strain identification of B burgdorferi, the biopsy specimens were analyzed by cold single-strand conformation polymorphism of an amplified fragment of the outer surface protein C (ospC) gene. Further single-strand conformation polymorphism patterns of amplified ospC genes from culture isolates were compared with polymerase chain reaction products obtained directly from erythema migrans biopsy specimens.

SETTING:

A private dermatology office and a university medical center outpatient department.

PATIENTS:

Sixteen patients presenting with erythema migrans.

RESULTS:

Two of the 16 patients in this cohort were infected with 2 B burgdorferi sensu stricto strains, as evidenced by 2 ospC alleles in their skin biopsy results.

CONCLUSION:

This is the first documented description of the existence of more than a single strain of B burgdorferi sensu stricto in a human specimen.

Arch Dermatol. 1999 Nov;135(11):1329-33. Comparative Study; Research Support, Non-U.S. Gov’t

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