Species of Borrelia burgdorferi complex that cause borrelial lymphocytoma in France

Background Only about 30 cases of borrelial lymphocytoma (BL) with identification of the causative species of Borrelia have been published to date, mainly from Eastern or Central European countries. Objectives To identify the species of B. burgdorferi complex responsible for BL in France. Methods Nine patients with BL acquired in France and for whom skin samples were sent to the national reference centre laboratory between 1994 and 2007 were included in this retrospective study. Direct detection of Borrelia in skin samples was made by polymerase chain reaction targeting the fla gene. Culture was performed when technically possible, and identification of each species was made by hybridization of a fragment of the fla gene with a panel of species-specific oligonucleotides. Results Borrelia afzelii was identified in three cases, B. garinii and B. burgdorferi sensu stricto in one case each. Culture was positive in only one case ( B. garinii). Conclusions Borrelia afzelii seems to be the predominant species of Borrelia responsible for BL in France, as already reported in other European countries.