期刊
NEW ENGLAND JOURNAL OF MEDICINE
卷 368, 期 3, 页码 240-245出版社
MASSACHUSETTS MEDICAL SOC
DOI: 10.1056/NEJMoa1209039
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资金
- National Institutes of Health [R41 AI 078631, R21 AI 082436]
- Evelyn Lilly Lutz Foundation
Ixodes ticks serve as vectors for Borrelia burgdorferi, the agent of Lyme disease. Globally, these ticks often concurrently harbor B. miyamotoi, a spirochete that is classified within the relapsing-fever group of spirochetes. Although humans presumably are exposed to B. miyamotoi, there are limited data suggesting disease attributable to it. We report a case of progressive mental deterioration in an older, immunocompromised patient, and even though Koch's postulates were not met, we posit B. miyamotoi as the cause, owing to its direct detection in cerebrospinal fluid (CSF) with the use of microscopy and a polymerase-chain-reaction (PCR) assay. It is likely that B. miyamotoi is an underrecognized cause of disease, especially in sites where Lyme disease is endemic.
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