CRONIC BORRELIOSIS HERMSII MIMICKING CHRONIC LYME BORRESIOSIS. Paul E. Lovoie, Pacific Presbyterian Medical Center, San Francisco, Tom G. Schwan, Willy Burgdorfer, Rocky Mountain Laboratory (NIH), Hamilton, MT.

The discovery of Borrelia burgdorferi (Bb) has established the concept that a borrelia can be the inciting agent in a number of chronic disease presentations. The relapsing fever borreliae are numerous in specie worldwide. Previously, they were thought to cause illness that remitted spontaneously after a limited number of relapses. We describe three cases with similar multisystem chronic illness in patients with ample exposure to Ornithodorus hermsii (Oh), the vector of B. hermsii (BH), who had no known exposure to Ixodes pacificus, the western vector of Bb.

Case PAK is a 56 y/o physician’s wife c/o chronic left facial pain, chronic low back pain, polyarthralgias, RUE tremor, & prominent fatigue. A sudden prostrating febrile illness associated with an expanding left breast annule at the site of an arthropod bite occurred 9/81. In 10/82 she developed right cervical radiculitis with a RUE tremor. Left trigeminal neuralgia started 8/85. Polyarthralgias & myalgias commenced 9/86. Her Oh exposure included rural WY 1935-45, rural CO & UT 7/70, & high Sierras 10/82. Cranial MRI showed high reflectance focal signals in deep white matter. RML IFA showed Bb 1:64, Bh 1:28.

Case RSF is a 46 y/o Calgary, Albert man c/o profound fatigue, ectopy, migratory oligoarthralgias, parestheslas, & lighting pains. He experienced a large expanding annule with central clearing lasting 10 days at the site of an arthropod bite which occurred while he was in his backyard 6/86. Multisystem system symptoms appeared 7/86 and remitted briefly in 10/86 when lightning pains first appeared. Migratory arthralgias appeared 6/87 with generalized stiffness following. IFA showed Bb 1:64, Bh 1:256.

Case RG is a 41 y/o male self-employed gold-miner from Fort Fraser, BC who presented c/o intense generalized polyarthralgias, previous oligoarthritis, severe headaches, prominent fatigue and malaise, variable RLQ abdominal pain, & intellectual dysfunction. The unrelenting headache appeared 9/85 soon after an unidentified arthropod bite while mining in northern BC. Chronic constitutional symptoms appeared 7/86 leading to disability. Oligoarthritis and polyarthralgias appeared 8/87 & were associated with recurrent headache, exercise intolerance, confusion and memory loss. IFA showed Bb 1:64, Bh 1:128.

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