Simultaneous isolation of Borrelia burgdorferi sensu lato from blood and cerebrospinal fluid in three patients with multiple erythema migrans

Abstract

Slovenia is a highly endemic region for Lyme borreliosis. We present three patients with multiple erythema migrans and simultaneous isolation of Borrelia burgdorferi sensu lato from blood and cerebrospinal fluid. The patients were identified in a prospective study on children with multiple erythema migrans in whom central nervous system involvement was actively searched. The patients had no obvious symptoms and signs of central nervous system involvement. At the end of 14-day treatment with ceftriaxone the patients were free of signs and symptoms of borrelial infection. We stressed the importance of cerebrospinal fluid investigations and early appropriate antibiotic treatment in these patients.