Meningoencephalitis from Borrelia miyamotoi in an immunocompromised patient.
Meningoencephalitis from Borrelia miyamotoi in an immunocompromised patient.
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免疫功能低下的患者宫山毛虫病的脑膜脑炎。
DOI：
10.1056/nejmoa1209039
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发表时间：
2013-01-17
期刊：
影响因子：
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通讯作者：
Telford SR 3rd
中科院分区：
文献类型：
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作者：
Gugliotta JL;Goethert HK;Berardi VP;Telford SR 3rd
硬蜱是莱姆病的病原体伯氏疏螺旋体的媒介。在全球范围内，这些扁虱经常同时携带宫本螺旋体，这是一种螺旋体，被归类为螺旋体复发热组。尽管人类可能接触到宫本杆菌，但表明可归因于它的疾病的数据有限。我们报告了一例老年免疫受损患者的进行性精神恶化的病例，尽管没有满足Koch的假设，但我们假设Miyamotoi杆菌是原因，因为使用显微镜和聚合酶链式反应(PCR)分析在脑脊液(CSF)中直接检测到它。宫本杆菌很可能是一种被忽视的致病原因，特别是在莱姆病流行的地方。
Ixodes ticks serve as vectors for Borrelia burgdorferi, the agent of Lyme disease. Globally, these ticks often concurrently harbor B. miyamotoi, a spirochete that is classified within the relapsing-fever group of spirochetes. Although humans presumably are exposed to B. miyamotoi, there are limited data suggesting disease attributable to it. We report a case of progressive mental deterioration in an older, immunocompromised patient, and even though Koch’s postulates were not met, we posit B. miyamotoi as the cause, owing to its direct detection in cerebrospinal fluid (CSF) with the use of microscopy and a polymerase-chain-reaction (PCR) assay. It is likely that B. miyamotoi is an underrecognized cause of disease, especially in sites where Lyme disease is endemic.