Borrelia miyamotoiとライム病ボレリアの共感染により認められた遊走性紅斑

・登山後，発熱，軽度肝機能障害，遊走性紅斑を呈した．

・患者血清において抗ライム病抗体と抗GlpQ抗体が陽性であり，皮膚生検組織を用いたPCR法でライム病ボレリアDNAが検出された．

・Borrelia miyamotoi（B. miyamotoi）とライム病ボレリアの共感染と診断した．

・ミノサイクリンの内服によって軽快した．

・遊走性紅斑を呈する疾患に，ライム病だけでなくB. miyamotoi disease（BMD）も鑑別にあげることが重要である．

（「症例のポイント」より）

　

A case of erythema migrans caused by coinfection of Borrelia miyamotoi and Lyme disease borreliae

　

Oginezawa, Mahoko1）Orime, Mari2）Ito, Akiko3）Sato, Kozue4）Kawabata, Hiroki4）Abe, Richiro1） 1）Division of Dermatology, Niigata Medical University School of Medical and Dental Sciences 2）Nomoto Mayumi Skincare Clinic 3）Nagata Clinic 4）National Institute of Infectious Diseases

　

A 61-year-old woman developed fever, liver dysfunction, and erythema migrans after mountain climbing. Laboratory test revealed that anti- Borrelia antibody was positive, and B. garinii was detected by PCR in lesional skin sample. In addition, anti-GlpQ antibody was also positive. She was diagnosed with having coinfection with B. miyamotoi and Lyme disease borreliae. Her symptoms improved immediately with the treatment of minocycline. B. miyamotoi infection also needs to be included in the differential diagnosis of a case with erythema migrans after tick bites.