Table 1.

Demographic, clinical, and laboratory features in patients infected with suspected novel B burgdorferi sensu lato genospecies

	Patient 1	Patient 2	Patient 3	Patient 4	Patient 5	Patient 6
Demographic features
Age (years)	10	65	11	21	67	51
Sex	Male	Male	Male	Female	Female	Male
Tick exposure	Probable	Probable	Known bite	Probable	Probable	Known bite
Symptoms
Fever	Yes	Yes	Yes	No	Yes	Yes
Headache	Yes	Yes	Yes	No	Yes	Yes
Neck pain	Yes	Yes	Yes	No	No	No
Fatigue	Yes	Yes	Yes	No	Yes	No
Myalgia	Yes	Yes	No	No	Yes	Yes
Nausea or vomiting	Yes	No	Yes	No	Yes	Yes
Arthralgia (site)	No	No	No	Yes (left knee)	No	No
Other	Profound somnolence	‥	Confused speech	‥	Chills, abdominal and lumbar back pain, flashing lights	‥
Physical findings
Measuredtemperature (°C)	40	NA	39·7	Afebrile	38·2	NA
Rash	Many erythematous macules on face, trunk, arms (figure 1A)*	NA	Initial macule, enlarged to erythema migrans; diffuse macular rash after single dose of doxycycline; many erythema migrans 28 days later	NA	Many erythematous macules on trunk and upper extremities	2 × 2 cm macule on leg at site of possible tick bite
Other	‥	‥	‥	Swelling left knee	‥	‥
Laboratory results [normal range for adults and children aged 10–11 years combined]
Days of illness before specimen collection for PCR	1	4	2	34	3	1
oppA1 PCR melting temperature (°C)	61·24	60·75	60·83	61·19	60·56	60·38
Crossing point	30·88	29·58	29·82	34·20	26·48	30·63
Estimated number of oppA1 copies per mL	4·2×105	9·4×105	8·1×105	Not determined	6·4×106	4·9×105
White blood cell count (×10−9/L) [3·4–10·5]	7·4	3·4	4·6	NA	12·4	5·3
Lymphocyte count (×10−9/L) [0·90–6·50]	0·74	0·31	0·44	NA	0·93	0·30
Platelet count (×10−9/L) [150–450]	184	113	122	NA	215	150
Haemoglobin (g/dL) [12·0–17·5]	14	NA	14·7	NA	9·6	15·5
Aspartate aminotransferase (U/L) [8–60]	46	NA	NA	NA	118	23
Alanine aminotransferase (U/L) [7–55]	33	NA	NA	NA	69	27
Treatment and outcome
Antimicrobial therapy	Ceftriaxone (1 day), amoxicillin (21 days; dosage NA)	Doxycycline (dosage and duration NA)	Initial treatment: doxycycline (discontinued after 1 × 50 mg dose)†	Initial treatment: doxycycline (100 mg twice per day for 28 days)‡	Doxycycline (100 mg twice per day for 21 days)	Doxycycline (100 mg twice per day for 14 days)
Hospital admission	4 Days	No	No	No	1 day	No
Outcome	Recovered	Recovered	Recovered	Persistent joint pain	Improved, lingering fatigue (pre-existing anaemia)	Recovered

Clinical findings and symptoms were recorded by medical staff at time of initial patient presentation. NA=not available.

^*Rash was reported by patient’s caregiver to involve the palms and soles, but this was not documented in the medical record.

^†Subsequent treatment for patient 3 was initiated 3 weeks after illness onset, and consisted of cefuroxime, 500 mg twice per day for 21 days.

^‡For patient 4, subsequent treatment consisted of amoxicillin, 500 mg three times per day for 21 days.