Positive report at bottom of page posted 13th August 2010

Here is a case from 2010 - tracking the clinical picture at the time of the development of erythema migrans

This 61 year old man was tested positive to Borrelia Burgdorferi in 2009 by nested PCR - blood sample

He presented on Friday 23rd July 2010 with a painful swelling on the back (at the base of the right scapula). He had noted this swelling increasing in size for 48 hours. He had not noticed it before that however gave a history of working in the garden on both days of the previous weekend. He is the husband of the woman referred to in proof 2 on the Lyme information for Doctors page (same garden).

Ovoid red swelling measuring 5cm vertically and 3.5cm across.

Clinically a lot of doctors in Australia call this allergy to tick bite if it is a known tick, which at this point is a variable in this presentation. The swelling and the amount of induration here points to erythema migrans.

Here is a photo at day 6 (we will assume). Punch biopsies have been taken form the punctum site which is still clearly visible, and from the leading edge of the lesion. They have been sent for Borrelia PCR. Would NSW health please note the sequencing will be done at a NATA accredited laboratory.

Day 6 the 23rd July 2010

 

Monday 26th July. Here is a photo on this date, now at day 9. Measurement is now 7.2 by 4.5 cm

Day 9

Notice how the inflammation spread past the lower black mark which was the biopsy of the leading edge. 
The man has been on doxycycline 200mg since Saturday. We await the PCR reports which will take many days.

YES ITS POSITIVE 

Here is the report

A further case

It is followed quickly by another man aged 67 years who presented within days of 3 tick bites. Two of which were clearly Erythema Migrans but one was far more prominent. A tissue sample was taken by 2mm punch biopsy and was reported positive for Borrelia PCR. There was insufficient DNA for confirmation by sequencing unlike the case above.