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• Vol.44 No.4/5
• CLINICA NEUROL, 44: 299−302, 2004
• Vol.44 No.4/5 contents

Brief Clinical Note

Eosinophilic fasciitis associated with Borrelia afzelii infection

Osamu Kikuchi, M.D.¹⁾, Hiroyuki Murai, M.D.¹⁾, Koji Ikezoe, M.D.¹⁾, Masakazu Kawajiri, M.D.¹⁾, Yasumasa Ohyagi, M.D.¹⁾, Emiko Isogai, D.V.M.²⁾ and Jun-ichi Kira, M.D.¹⁾

¹⁾Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University
²⁾Department of Preventive Dentistry, Health Sciences University of Hokkaido

A 58-year-old woman suffered from stiffness, swelling, rubor and muscle pain in the extremities one month after she climbed a mountain in Kyushu, an island in southern Japan. On admission, mild proximal weakness was present in the extremities. Her range of motion in the extremities was limited due to firm skin and subcutaneous stiffness which was similar to scleroderma. She showed peripheral blood eosinophilia and hypergammaglobulinemia as well as a high erythrocyte sedimentation rate. An IgM antibody against Borrelia afzelii was positive. MRI of the skeletal muscles demonstrated enhancing fascia around the biceps brachii muscle, and a biopsy specimen revealed perivascular infiltration of mononuclear cells within the hypertrophic fascia. Eosinophilic infiltration was absent. We treated the patient with prednisolone, doxycycline and amoxicillin, which alleviated the symptoms. This is the first report to show that Borrelia afzelii was involved in eosinophilic fasciitis.

(CLINICA NEUROL, 44: 299−302, 2004)
key words: eosinophilic fasciitis, borreliosis, Borrelia afzelii

(Received: 11-Aug-03)