Abstract
Although Lyme borreliosis has been linked to hepatitis in early stages of infection, the association of chronic Borrelia burgdorferi infection with hepatic disease remains largely unexplored. We present the case of a 53-year-old woman diagnosed with Lyme disease who developed acute hepatitis with elevated liver enzymes while on antibiotic treatment. Histological examination of liver biopsy tissue revealed spirochetes dispersed throughout the hepatic parenchyma, and the spirochetes were identified as Borrelia burgdorferi by molecular testing with specific DNA probes. Motile spirochetes were also isolated from the patient’s blood culture, and the isolate was identified as Borrelia burgdorferi sensu stricto by two independent laboratories using molecular techniques. These findings indicate that the patient had active, systemic Borrelia burgdorferi infection and consequent Lyme hepatitis, despite antibiotic therapy.
Highlights
Morgellons disease (MD) is a complex skin disorder characterized by ulcerating lesions that have protruding or embedded filaments
Our study using multiple detection methods confirms that MD is a true somatic illness associated with Borrelia spirochetes that cause Lyme disease
Histological examination – dermatological specimens All patients were clinically diagnosed with MD by a healthcare provider based on the presence of skin lesions and/or skin crawling sensations with intradermal filaments that were visible with a hand-held microscope, as described in previous publications [4,5,6,7,8,9]
Summary
Morgellons disease (MD) is a complex skin disorder characterized by ulcerating lesions that have protruding or embedded filaments. Histological, electron microscopic and PCR studies of dermatological tissue containing filamentous inclusions from four MD patients confirmed the presence of Bb sensu stricto spirochetes [6,7]. A case study of an MD patient in Australia reported that endpoint PCR and Basic Local Alignment Search Tool (BLAST) analysis resulted in the detection and identification of Borrelia garinii [8]. These preliminary studies suggest that MD may be a particular manifestation of LD and that strains of Bb sensu stricto and Bb sensu lato are implicated as etiologic agents [7,8]
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