Borrelia species is a topic covered in the Johns Hopkins Antibiotic (ABX) Guide.

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  • Epidemic, louse-borne relapsing fever (LBRF): person-person transmission of Borrelial 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 Figure).
  • 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, essentially all cases of TBRF have been associated w/ 2 spp. of ticks: O. hermsii and O. turicatae.
      • The three main agents of TBRF in US are B. hermsii, B. parkeri, and B. turicatae.
        • Microscopic inspection cannot distinguish bacterial spp. B. hermsii can be identified by monoclonal antibody, and most Borrelia spp. can be sorted by PCR analysis using genome species-specific markers though neither of these are routinely available in most commercial laboratories.
      • 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.
  • Borrelia miyamotoi: recently described human pathogen that is tick-transmitted (Ixodes) and may cause febrile illness and meningoencephalitis [8].
    • May cause febrile illness of nonspecific nature, but report from Russia described some with erythema migrans, but unclear if due to Lyme disease co-infection (with B. burgdorferi sensu stricto) [11].
      • Easily confused with HGA, HME or acute Lyme disease without a rash.
    • Cases seen in Europe and US.
      • Same distribution as Lyme disease as appears spread in US by Ixodes scapularis.
        • Descriptions in New England, mid-Atlantic and upper Midwest states.
    • Sublclinical infections likely as up to 5-10% seropositive in some New England communities.
  • Borrelia mayonii (candidate name, 2016): member of B. burgdorferi sensu latu that has high spirochetemic load in blood. Found in Ixodes ticks.
    • Six pts described to date.
    • 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: September 3, 2016