Aseptic meningitis and adult respiratory distress syndrome caused by Borrelia persica

Abstract

The occurrence of some of the clinical complications of tickborne relapsing fever varies with Borrelia species. For example, adult respiratory distress syndrome (ARDS), a newly reported complication, was described so far only with B. hermsii infection. A previously healthy young Israeli man was admitted for fever and headache and was diagnosed as aseptic meningitis. Shortly before the lumbar puncture was performed he started to experience shortness of breath and developed acute respiratory insufficiency necessitating mechanical ventilation. Radiography, which was normal on admission, demonstrated bilateral lung infiltrates consistent with ARDS. Spirochetes suggestive of Borrelia were seen on a thick blood smear preparation, and polymerase chain reaction was positive for B. persica. This is the first reported case of ARDS in association with Borrelia spp. occurring outside the U.S.A. and the first one due to B. persica infection.