Borrelia species
MICROBIOLOGY
- Lyme disease: see separate module for Borellia burgdorferi sensu latu.
- Epidemic, louse-borne relapsing fever (LBRF): person-person transmission of Borrelia species such as B. recurrentis (like typhus) by human body louse (Pediculus humanus).
- Worldwide infection (ex. S’ Pacific)
- B. recurrentis only causes epidemic louse-borne RF.
- Spirochete, helical 5-40µm long with 3-10 spirals (see Fig 1).
- Sporadic endemic, tick-borne relapsing fever (TBRF): tick-borne (Ornithodoros, soft ticks) reservoirs include rodents and small animals.
- Species:
- >15 Borrelia spp. cause endemic tick-borne RF.
- TBRF vectors and Borrelia spp.:
- In North America, all cases of TBRF have been associated w/ 2 spp. of soft ticks: O. hermsii and O. turicatae [Fig 2].
- These soft ticks do not attach for long but bite and feed on blood like chiggers or bedbugs, feeding at night.
- Bites are not painful; sometimes, crusted blood can be seen on the skin.
- Usually live in nests of chipmunks, squirrels and small mammals.
- These soft ticks do not attach for long but bite and feed on blood like chiggers or bedbugs, feeding at night.
- The three main agents of TBRF in the U.S. are B. hermsii, B. parkeri, and B. turicatae.
- Microscopic inspection cannot distinguish bacterial spp.
- B. hermsii can be identified by a monoclonal antibody, and most Borrelia spp. can be sorted by PCR analysis using genome species-specific markers. However, neither of these is routinely available in most commercial laboratories.
- Microscopic inspection cannot distinguish bacterial spp.
- Borrelia duttoni, transmitted by the Ornithodoros moubata tick vectors, is a cause of TBRF in Tanzania and other parts of Africa.
- It tends to be more severe than usual TBRF.
- In North America, all cases of TBRF have been associated w/ 2 spp. of soft ticks: O. hermsii and O. turicatae [Fig 2].
- Species:
- Borrelia miyamotoi: recently described human pathogen tick-transmitted (Ixodes) and may cause a febrile illness similar to human granulocytic anaplasmosis and meningoencephalitis[18].
- It may cause febrile illness of nonspecific nature. Still, a report from Russia described some with erythema migrans, but unclear if due to Lyme disease co-infection (with B. burgdorferisensu latu)[21].
- Easily confused with HGA, HME, or acute Lyme disease without a rash.
- Presentations may appear to mimic bacterial sepsis with fever, elevated LFTs and thrombocytopenia.
- Easily confused with HGA, HME, or acute Lyme disease without a rash.
- Cases are seen in Europe and U.S.
- The same distribution as Lyme disease as it appears to spread in the U.S. by Ixodes scapularis.
- Descriptions in New England, mid-Atlantic and upper Midwest states
- The same distribution as Lyme disease as it appears to spread in the U.S. by Ixodes scapularis.
- Subclinical infections are likely as up to 5-10% seropositive in some New England communities.
- It may cause febrile illness of nonspecific nature. Still, a report from Russia described some with erythema migrans, but unclear if due to Lyme disease co-infection (with B. burgdorferisensu latu)[21].
- Borrelia mayonii (described in 2016): a member of B. burgdorferi sensu latu with a high blood spirochetemic load, unlike Lyme disease. Also transmitted by Ixodes ticks.
- The few patients reported were all from MN and WI only.
- Febrile illness that may be severe enough to prompt hospitalization
- Rash: ranges from erythema migrans-like to diffuse maculopapular
- Arthritis
- Neurologic
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Last updated: August 8, 2022
Citation
Auwaerter, Paul. "Borrelia Species." Johns Hopkins ABX Guide, The Johns Hopkins University, 2022. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540063/3.2/Borrelia_species.
Auwaerter P. Borrelia species. Johns Hopkins ABX Guide. The Johns Hopkins University; 2022. https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540063/3.2/Borrelia_species. Accessed December 1, 2024.
Auwaerter, P. (2022). Borrelia species. In Johns Hopkins ABX Guide. The Johns Hopkins University. https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540063/3.2/Borrelia_species
Auwaerter P. Borrelia Species [Internet]. In: Johns Hopkins ABX Guide. The Johns Hopkins University; 2022. [cited 2024 December 01]. Available from: https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540063/3.2/Borrelia_species.
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