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Journal of Clinical Microbiology, June 1999, p. 2027-2030, Vol. 37, No. 6
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Tick-Borne Relapsing Fever Imported from West Africa: Diagnosis by Quantitative Buffy Coat Analysis and In Vitro Culture of Borrelia crocidurae

Alje P. van Dam,1,* Tom van Gool,1 José C. F. M. Wetsteyn,2 and Jacob Dankert1

Departments of Medical Microbiology1 and Infectious Diseases, Tropical Medicine and AIDS,2 Academic Medical Centre, 1105 AZ Amsterdam, The Netherlands

Received 14 September 1998/Returned for modification 2 December 1998/Accepted 17 March 1999

West African tick-borne relapsing fever (TBRF) is difficult to diagnose due to the low number of spirochetes in the bloodstream of patients. Previously, the causative microorganism, Borrelia crocidurae, had never been cultured in vitro. TBRF was rapidly diagnosed for two patients returning from western Africa with fever of unknown origin by quantitative buffy coat (QBC) analysis. Diagnosis was confirmed by intraperitoneal inoculation of blood specimens from patients into laboratory mice. In vitro experiments showed that QBC analysis may be as much as 100-fold more sensitive than thick smear. Spirochetes were also cultured from blood samples from both patients in modified Kelly's medium and were identified as B. crocidurae by partial sequencing of the PCR-amplified rrs gene.

* Corresponding author. Mailing address: Department of Medical Microbiology, Academic Medical Centre, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands. Phone: 31 20 566 4863. Fax: 31 20 697 9271. E-mail: a.p.vandam{at}amc.uva.nl.

Journal of Clinical Microbiology, June 1999, p. 2027-2030, Vol. 37, No. 6
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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