Figure.

Laboratory findings of hemorrhagic diathesis in an 18-year-old Somalian refugee to Germany with Borrelia recurrentis infection, August 2015. A) Time course of coagulation parameters (thrombocytopenia and prolongation of activated partial thromboplastin time [APTT]). B) Extracellular spirochetes demonstrated by light microscopy (arrowhead). Representative image detail from thin blood smear, Giemsa stain. Scale bar indicates .5 μm. C) Molecular phylogenetic analysis of B. recurrentis detected in patient blood. Multiple alignment of complete glpQ sequence (1,002 bp) with published reference sequences was performed by using BioEdit 7.0.5.3 software (Ibis Biosciences, Carlsbad, CA, USA) and analyzed by MEGA6.06 (http://www.megasoftware.net). The evolutionary history was inferred by using maximum-likelihood method based on the Tamura-Nei model. Bootstrap values are shown at the node of branches (1,000 bootstrap replications). The complete glpQ sequence was deposited in GenBank under accession no. KT764112. Scale bar indicates nucleotide substitutions per site.