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Reccurent erythema migrans as a persistent infection
1Dpt.of Dermatovenerology, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic. danka.svecova@faneba.sk
Summary
Recurrent erythema migrans (EM) can result from reinfection or persistent infection despite antibiotic treatment. Intravenous cephalosporin effectively treated recurrent EM with systemic symptoms, indicating its suitability for persistent borrelial infections.
Area of Science:
- Infectious Diseases
- Dermatology
- Microbiology
Background:
- Early antibiotic therapy for erythema migrans (EM) is crucial to prevent disease spread.
- Recurrent EM cases pose diagnostic and therapeutic challenges.
Observation:
- A 73-year-old woman experienced five recurrent episodes of EM despite adequate antibiotic treatment.
- No tick bite or recent travel to endemic areas preceded most episodes.
- Serological tests were initially negative, then borderline, and later confirmed Borrelia burgdorferi.
- Peripheral blood PCR detected Borrelia burgdorferi DNA in the latest episode.
Findings:
- Recurrent EM can occur due to reinfection or persistent infection.
- Intravenous cephalosporin demonstrated efficacy in treating both cutaneous and extracutaneous symptoms of recurrent borrelial infection.
Implications:
- Intravenous cephalosporin is a potential treatment for recurrent borrelial infections, especially with systemic involvement.
- Further investigation into the mechanisms of persistent or recurrent Lyme disease is warranted.
- This case highlights the importance of considering persistent infection in recurrent EM cases.
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