As a spirochete.

A 59-year-old woman, admitted to the emergency department for a fall, had a subfebrile episode up to 38 °C without localized symptoms of infection. She had relapsed follicular lymphoma. She had not recently been administered chemotherapy nor had she travelled outside of France. Laboratory tests revealed elevated CRP (164 mg/L) without hyperleucocytosis. Her urinary strip test was negative. No stool culture was performed. After 4 days of incubation, only the aerobic blood culture was positive (BACT'ALERT), with Gram-negative spiral-shaped bacteria resembling spirochetes (A,B,C x1000). Treatment was initiated with imipenem and gentamicin. The next day, the microaerophilic culture grew Campylobacter jejuni (MALDI Bruker), which is a common cause of enteritis but rarely septicemic. Campylobacter typically morphology, small nearly colorless curved bacilli (D) differ greatly from spirochetes. In our case, spiral bacilli did resemble Borrelia [1], which is an emerging bacterium in our region. However, Borrelia only stains with May-Grünwald Giemsa(E) but not Gram.