Ultrastructure of Borrelia burgdorferi in tissues of patients with Lyme disease

Spirochetal organisms were sought in 18 skin and 4 synovial membrane specimens obtained by biopsy from 22 Lyme disease patients. The presence of spirochetes in body tissues was histologically demonstrated in one patient with lymphadenosis benigna cutis, one patient with acrodermatitis chronica atrophicans and in one patient with active arthritis. The organisms were 5-30 microns long and 0.12-0.25 microns thick, had 8 or 11 flagella arising from both ends of the body, and their ultrastructure was analogous to that of cultured Borrelia burgdorferi strains. They were located intra- or perivascularly, or in the collagenous connective tissue of the skin and synovium. This implies that Lyme spirochetes may have a potential to survive in body tissues and cause injury to blood vessels.