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Human necrotizing splenitis caused by Borrelia burgdorferi
1Department of Pathology, Mount Sinai Hospital, Hartford, Connecticut 06112.
American Journal of Clinical Pathology
|April 1, 1989
Summary
This case report details a rare instance of acute necrotizing splenitis in a human caused by Borrelia burgdorferi, the bacterium responsible for Lyme disease. Diagnosis was confirmed via splenic tissue analysis and serological testing.
Area of Science:
- Infectious Diseases
- Microbiology
- Pathology
Background:
- Splenic abscesses typically present with severe abdominal pain and require prompt diagnosis and treatment.
- Bacterial infections are common causes of splenic abscesses, but spirochetal involvement is rare.
Observation:
- A 25-year-old male presented with acute left upper quadrant pain, initially suspected as a splenic abscess.
- Histopathology revealed extensive splenic necrosis and inflammation, with negative microbial cultures.
- Dieterle silver stain identified numerous spirochetal bacteria resembling Borrelia spp.
Findings:
- Serological tests confirmed the presence of antibodies against Borrelia burgdorferi, the causative agent of Lyme disease.
- This case represents the first documented human infection of acute necrotizing splenitis attributed to Borrelia burgdorferi.
Implications:
- Highlights the potential for Borrelia burgdorferi to cause severe splenic pathology beyond typical Lyme disease manifestations.
- Suggests considering Borrelia burgdorferi in the differential diagnosis of splenic abscesses, especially when conventional pathogens are not identified.
- Underscores the importance of specialized stains and serological testing for diagnosing atypical infections.