PCR did not reveal any Borrelia antigen in CSF. The diagnosis
and treatment of possible but not confirmed neuroborreliosis is a
clinical challenge. The clinical response to treatment may be the best
option in these cases.

The occurrence of Toxoplasma gondii and Borrelia burgdorferi sensu lato in
Ixodes ricinus ticks from east Poland with the use of pcr.

Sroka J, Szymanska J, Wojcik-Fatla A.

Department of Occupational Biohazards, Institute of Agricultural Medicine,
Jaczewskiego 2, 20-090 Lublin, Poland. jack@galen.imw.lublin.pl

715 Ixodes ricinus ticks from 4 regions of Lublin macroregion (Piotrowice,
Polesie National Park, Dabrowa and Leczynsko-Wlodawskie Lakeland) were examined
for the presence of Borrelia burgdorferi sensu lato and Toxoplasma gondi, using
polymerase chain reaction (PCR) and nested-PCR methods. The clonal type of
samples tested positive for T. gondii was identified by amplification and
fragmenting with restrictions enzymes (RFLP-restriction fragment length
polymorphism). Positive results were confirmed by sequencing.

To read more: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=20047269&retmode=ref&cmd=prlinks
PMID: 20047269

Background: Most cases of human babesiosis in North America are caused
by Babesia microti, which is endemic in the northeastern and upper
midwestern United States. Although the disease is usually transmitted by
a tick bite, there has been an increase in the number of
transfusion-transmitted cases reported. We describe a fatal case of
transfusion-transmitted babesiosis in a nonendemic state, Delaware.

Case Report: The patient was a 43-year-old Caucasian woman with history
of transfusion-dependent Diamond-Blackfan syndrome, hepatitis C, and
splenectomy. She was admitted initially for presumptive pneumonia. The
next day, a routine examination of the peripheral blood smears revealed
numerous intraerythrocytic ring forms, consistent with Babesia. The
parasitemia was approximately 5% to 6%. The diagnosis was confirmed by
positive polymerase chain reaction (PCR) for B. microti DNA and high
titer of antibody to B. microti (1:2048). Despite aggressive therapy
including clindamycin and quinine antibiotics, the patient expired 3
days after admission. Subsequently, 13 blood donors were tested for B.
microti. All tested donors were negative by PCR. However, one donor
living in New Jersey had a significant elevated B. microti antibody
titer (1:1024).

Conclusions: We believe that this is the first reported case of
transfusion-transmitted babesiosis in Delaware, a nonendemic state. Our
case illustrates that clinicians should consider babesiosis in the
differential diagnosis of immunocompromised patients who have fever and
recent transfusion history, even in areas where babesiosis is not
endemic. It also demonstrates the need for better preventive strategies
including more sensitive, specific, and rapid blood donor screening
tests to prevent transfusion-transmitted babesiosis.

http://dx.doi.org/10.1111/j.1537-2995.2009.02454.x