Approximately 45% of untreated United States patients with early Lyme disease associated with erythema migrans have a positive blood culture based on microscopic detection of Borrelia burgdorferi in Barbour-Stoenner-Kelly medium after 2 to 12 weeks of incubation. In this study we demonstrate that the yield of blood cultures can be significantly increased to 70.8% by the use of a combined culture-quantitative PCR technique and that among those patients found to have a positive blood culture, positivity was detected in over 90% within just 7 days of incubation. Patients with multiple erythema migrans were almost uniformly culture positive by this technique.
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