An Unusual Case of Serologically Confirmed Post-Partum Lyme Disease Following an Asymptomatic Borrelia burgdorferi Infection Acquired during Pregnancy and Lacking Vertical Transmission in Utero

Abstract

In this report, we describe a 23-year-old female who, while pregnant, was exposed to Borrelia burgdorferi but did not develop significant signs or symptoms (joint pain, arthritis) of Lyme disease until shortly after delivering a healthy child at term. Serologic testing confirmed infection with B. burgdorferi. A 3-week course of treatment with doxycycline was completely curative. There was no evidence for congenital or perinatal transmission of this pathogen at any point pre-term or postnatally. The key reasons that could account for this unique clinical scenario are discussed in the context of previously published related reports.

Keywords: Borrelia burgdorferi; Lyme disease; Western blot; arthritis; congenital transmission; pregnancy.

Figure 1

Photomicrographs of a maintenance culture of the strain BL206 of B. burgdorferi derived from a blood culture of a Lyme disease patient seen at the New York Medical College Lyme Disease Clinic in 1999 [38]; (panel A), phase contrast microscopy, at 200× magnification; (panel B), phase contrast microscopy at 500× magnification. It is noteworthy that these types of images, representative of B. burgdorferi’s unique shape, have rarely, if ever, been reported in the various past case study reports claiming fetal damage due to a congenitally acquired infection.