Lyme disease (LD) is a complex multisystem infection caused by Borrelia burgdorferi. Chronic Lyme disease (CLD) describes patients who suffer from chronic symptoms after what is thought to be adequate antibiotic therapy. Diagnosis of a persistent infection is difficult because of the poor sensitivity of currently available methods. Although the organism can be cultured in enriched artificial medium (BSK), culture has a very low sensitivity outside of samples for the acute disease, specifically the lesions of erythema migrans in which the reported culture sensitivity ranges from 20 to 90 percent. In 1998, Philips et al. described a new medium (MPM) and methods for culture by which they cultured Borrelia organisms from 43 of 47 patients with CLD, all of whom had relapsed after long-term oral and intravenous antibiotics. This new culture medium and method would be a major advance in the laboratory diagnosis of CLD. We tested 19 blood samples from 18 patients at the NIH seen in 1999 using the new media and methods of Philips et al. Cases included 11 patients with CLD, five with Lyme arthritis, one patient recovered from LD, and one with early LD. In addition, comparative studies using a control strain of Borrelia species were used to compare the growth characteristics of MPM to those of BSK. We were unable to recover the Borrelia spirochete from any of the blood cultures using either MPM or BSK. In addition, serial dilution studies using a control strain of Borrelia showed that BSK was more sensitive than MPM for the detection of Borrelia organisms.
