Clinlab Navigator

Borrelia Miyamotoi

Borrelia miyamotoi is a member of the relapsing fever group of Borrelia that was first reported to cause human disease in the United States in 2013. It is transmitted by the same tick species that transmits Lyme disease, Ixodes scapularis. B. miyamotoi is geographically widespread. A survey of nymphal Ixodes scapularis ticks in 11 Lyme disease–endemic states reported that 2% were infected with B miyamotoi and 20% with B burgdorferi.

Unlike with Lyme disease, patients infected with B miyamotoi typically do not develop a rash. The most common clinical presentation is fever accompanied by headache (96%), myalgia (84%), arthralgia (76%), and malaise/fatigue (82%). Fever may be relapsing in untreated patients. Severely immunocompromised patients may develop chronic meningitis. Laboratory abnormalities include elevated liver enzymes in 75% of patients, leukopenia in 51% and thrombocytopenia in 60%. Leukopenia and thrombocytopenia are less commonly observed in patients with Lyme disease. Both doxycycline and amoxicillin appear to be effective for treatment of immunocompetent patients with this infection.

Patients infected with B miyamotoi may be misdiagnosed as having Lyme disease because this infection may cause positive results with enzyme-linked immunosorbent assays (EIA) used to diagnose Lyme disease. No diagnostic tests for B miyamotoi infection have been approved by the US Food and Drug Administration. Active infection is best diagnosed in a blood sample using polymerase chain reaction (PCR).

Molloy PJ, Telford SR III, Chowdri HR, et al. Borrelia miyamotoi disease in the northeastern United States: a case series. Ann Intern Med. 2015; 163(2):91-98

Updated Articles

Lyme Disease Serology

Lyme disease is caused by the spirochetes Borrelia burgdorferi and Borrelia garinii. It is the most common tick-borne infection in the United States and in Europe. In the U.S., Lyme disease is endemic in the Northeastern, mid-Atlantic and Upper…

New Articles

Autoimmune…

Autoantibody-mediated encephalitis is a group of inflammatory brain disorders characterized by neuropsychiatric symptoms and the presence of autoantibodies against neuronal antigens. Common clinical features include a change in behavior, psychosis,…

Blog

Opioid Overdose…

Natural opioids include morphine and codeine. Heroin is an illicit opioid synthesized from morphine. Semisynthetic opioids include drugs such as oxycodone, hydrocodone, hydromorphone, and oxymorphone. Methadone, tramadol and fentanyl are synthetic…