{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T09:41:27Z","timestamp":1792575687898,"version":"4.5.0"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      The clinical significance of transient\n                      <jats:italic>Borrelia burgdorferi<\/jats:italic>\n                      sensu lato complex (hereafter referred to as\n                      <jats:italic>B. burgdorferi<\/jats:italic>\n                      ) spirochetemia remains poorly understood and has rarely been documented. We report the isolation of viable\n                      <jats:italic>B. garinii<\/jats:italic>\n                      genospecies from the blood of a previously healthy child presenting with a\n                      <jats:italic>Streptococcus anginosus<\/jats:italic>\n                      group (SAG) brain abscess.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      An eight-year-old girl presented with four days of headache, fever, nausea, slightly reduced general condition, and mild facial asymmetry. Initial evaluation, including lumbar puncture, raised suspicion of viral meningitis or Lyme neuroborreliosis (LNB). Based on the differential diagnosis of Lyme disease, she was enrolled in the prospective BRILLIANT study (NCT06045416), with additional blood and cerebrospinal fluid (CSF) sampling for\n                      <jats:italic>B. burgdorferi<\/jats:italic>\n                      culture and serology. Following initial outpatient management, she re-presented with clinical deterioration and signs of raised intracranial pressure. Cranial magnetic resonance imaging revealed a brain abscess requiring surgical drainage. Abscess cultures yielded SAG. Dental treatment four days before symptom onset provided a plausible source of infectious spread. Treatment with intravenous ceftriaxone and metronidazole for six weeks resulted in complete clinical recovery and radiological improvement.\n                      <jats:italic>Borrelia burgdorferi<\/jats:italic>\n                      -specific two-tier serology and CSF culture remained negative. In contrast, blood plasma culture for\n                      <jats:italic>B. burgdorferi<\/jats:italic>\n                      obtained at initial presentation yielded viable spirochetes after seven weeks.\n                      <jats:italic>Borrelia burgdorferi<\/jats:italic>\n                      DNA was confirmed by\n                      <jats:italic>flaB<\/jats:italic>\n                      -targeted qPCR, and hybrid whole-genome sequencing generated a near-complete genome identifying\n                      <jats:italic>B. garinii<\/jats:italic>\n                      genospecies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This case demonstrates viable\n                      <jats:italic>B. garinii<\/jats:italic>\n                      spirochetemia without serological evidence of LNB, incidentally detected during investigation of a SAG brain abscess. It highlights the uncertain clinical significance of transient\n                      <jats:italic>B. burgdorferi<\/jats:italic>\n                      spirochetemia, and the importance of interpreting microbiological findings within the clinical context.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-026-03016-1","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T08:54:51Z","timestamp":1792572891000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Borrelia garinii spirochetemia in a previously healthy child presenting with Streptococcus anginosus group brain abscess: a case report"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2445-7134","authenticated-orcid":false,"given":"Beat M.","family":"Greiter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3057-0472","authenticated-orcid":false,"given":"Michael","family":"Hugelshofer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1263-5818","authenticated-orcid":false,"given":"Michelle","family":"Seiler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5300-664X","authenticated-orcid":false,"given":"Semjon","family":"Sidorov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3161-8703","authenticated-orcid":false,"given":"Annette","family":"Hackenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0166-2770","authenticated-orcid":false,"given":"Raimund","family":"Kottke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3564-8603","authenticated-orcid":false,"given":"Adrian","family":"Egli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1089-221X","authenticated-orcid":false,"given":"Niklaus","family":"Krayenb\u00fchl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2373-8804","authenticated-orcid":false,"given":"Christoph","family":"Berger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4312-9803","authenticated-orcid":false,"given":"Patrick M.","family":"Meyer Sauteur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"issue":"9814","key":"3016_CR1","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1016\/S0140-6736(11)60103-7","volume":"379","author":"G Stanek","year":"2012","unstructured":"Stanek G, Wormser GP, Gray J, Strle F. 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The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the Canton of Zurich, Switzerland (protocol no. 2023-00528).","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent for (i) participation in the BRILLIANT study and (ii) publication of this case report, including the use of the patient\u2019s health data, was obtained from the patient\u2019s parents.","order":3,"name":"Ethics","label":"Consent to participate and publish","group":{"name":"EthicsHeading","label":"Declarations"}}]}}