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Delayed hemolytic transfusion reaction, intravenous immunoglobulin, and rituximab

10-day post–tick challenge donors, became infected, which is in marked contrast with our findings of short-lived and relatively infrequent spirochetemia in Bb-infected SKH mice. These somewhat discrepant results could be explained partially by the use of syringeinoculated Borrelia and SKH mice in our studies rather than using Bb-infected ticks and the more traditionally preferred C3H mouse strain, as was done by Gabitch and colleagues. Another explanation, that we hypothesize, is that Bb is rapidly cleared from the peripheral circulation by splenic and hepatic macrophages or other phagocytic cells, at or about the same time that spirochetes are disseminating to target sites such as the urinary bladder but further testing, including the use of PCR, is needed to prove this possibility. Ginsburg and colleagues suggested another series of related experiments be performed in animals for the purpose of evaluating whether or not Bb remains infectious when processed and stored under a variety of blood storage conditions now in use at blood donor facilities in the United States. Our laboratory is in the process of conducting such studies, which will also include PCR analysis and which should provide key additional information on Bb-blood interaction phenomena occurring in the infected host that could be relevant toward a better understanding on why there is a lack of transfusion-associated Lyme disease.