A case of chronic progressive Lyme encephalitis as a manifestation of late Lyme neuroborreliosis

A 54-year-old female living in Europe presented with gait ataxia, dizziness, and bilateral hearing loss. Magnetic resonance imaging (MRI) revealed non-specific white matter changes. The patient’s condition gradually deteriorated over two years without diagnosis. The patient continued to decline cogn...

Full description

Bibliographic Details
Main Authors: Vivek Verma, Matthew Roman, Disha Shah, Marina Zaretskaya, Mohamed H. Yassin
Format: Article
Language:English
Published: MDPI AG 2014-12-01
Series:Infectious Disease Reports
Subjects:
Online Access:http://www.pagepress.org/journals/index.php/idr/article/view/5496
id doaj-6303c575e8d14b8caab2127662fb41fd
record_format Article
spelling doaj-6303c575e8d14b8caab2127662fb41fd2021-01-02T11:10:14ZengMDPI AGInfectious Disease Reports2036-74302036-74492014-12-016410.4081/idr.2014.54962972A case of chronic progressive Lyme encephalitis as a manifestation of late Lyme neuroborreliosisVivek Verma0Matthew Roman1Disha Shah2Marina Zaretskaya3Mohamed H. Yassin4Department of Medicine, University of Pittsburgh Medical Center, PADepartment of Medicine, University of Pittsburgh Medical Center, PADivision of Neurology, University of Pittsburgh Medical Center, PADivision of Neurology, University of Pittsburgh Medical Center, PADepartment of Medicine, Division of Infectious Diseases, University of Pittsburgh Medical Center, PAA 54-year-old female living in Europe presented with gait ataxia, dizziness, and bilateral hearing loss. Magnetic resonance imaging (MRI) revealed non-specific white matter changes. The patient’s condition gradually deteriorated over two years without diagnosis. The patient continued to decline cognitively and neurologically with worsening ataxia and upper motor neuron signs. Repeat MRI showed worsening white matter changes. Lumbar puncture, not previously done, showed positive Lyme testing. Treatment with intravenous ceftriaxone resulted in marked neurological improvement. Four years after symptom, the patient has short-term memory deficits and chronic fatigue, but is otherwise neurologically, cognitively, and functionally intact. Follow up MRI findings remain largely unchanged. Because cases of intraparenchymal or encephalopathic neuroborreliosis in America are lacking, so are treatment options. We present a rare case and discuss our experience with antibiotic treatment. This case lends evidence to define optimal treatment of this disease, imperative for hastening neurological recovery.http://www.pagepress.org/journals/index.php/idr/article/view/5496Lyme neuroborreliosis, Borrelia burgdorferi, encephalopathy
collection DOAJ
language English
format Article
sources DOAJ
author Vivek Verma
Matthew Roman
Disha Shah
Marina Zaretskaya
Mohamed H. Yassin
spellingShingle Vivek Verma
Matthew Roman
Disha Shah
Marina Zaretskaya
Mohamed H. Yassin
A case of chronic progressive Lyme encephalitis as a manifestation of late Lyme neuroborreliosis
Infectious Disease Reports
Lyme neuroborreliosis, Borrelia burgdorferi, encephalopathy
author_facet Vivek Verma
Matthew Roman
Disha Shah
Marina Zaretskaya
Mohamed H. Yassin
author_sort Vivek Verma
title A case of chronic progressive Lyme encephalitis as a manifestation of late Lyme neuroborreliosis
title_short A case of chronic progressive Lyme encephalitis as a manifestation of late Lyme neuroborreliosis
title_full A case of chronic progressive Lyme encephalitis as a manifestation of late Lyme neuroborreliosis
title_fullStr A case of chronic progressive Lyme encephalitis as a manifestation of late Lyme neuroborreliosis
title_full_unstemmed A case of chronic progressive Lyme encephalitis as a manifestation of late Lyme neuroborreliosis
title_sort case of chronic progressive lyme encephalitis as a manifestation of late lyme neuroborreliosis
publisher MDPI AG
series Infectious Disease Reports
issn 2036-7430
2036-7449
publishDate 2014-12-01
description A 54-year-old female living in Europe presented with gait ataxia, dizziness, and bilateral hearing loss. Magnetic resonance imaging (MRI) revealed non-specific white matter changes. The patient’s condition gradually deteriorated over two years without diagnosis. The patient continued to decline cognitively and neurologically with worsening ataxia and upper motor neuron signs. Repeat MRI showed worsening white matter changes. Lumbar puncture, not previously done, showed positive Lyme testing. Treatment with intravenous ceftriaxone resulted in marked neurological improvement. Four years after symptom, the patient has short-term memory deficits and chronic fatigue, but is otherwise neurologically, cognitively, and functionally intact. Follow up MRI findings remain largely unchanged. Because cases of intraparenchymal or encephalopathic neuroborreliosis in America are lacking, so are treatment options. We present a rare case and discuss our experience with antibiotic treatment. This case lends evidence to define optimal treatment of this disease, imperative for hastening neurological recovery.
topic Lyme neuroborreliosis, Borrelia burgdorferi, encephalopathy
url http://www.pagepress.org/journals/index.php/idr/article/view/5496
work_keys_str_mv AT vivekverma acaseofchronicprogressivelymeencephalitisasamanifestationoflatelymeneuroborreliosis
AT matthewroman acaseofchronicprogressivelymeencephalitisasamanifestationoflatelymeneuroborreliosis
AT dishashah acaseofchronicprogressivelymeencephalitisasamanifestationoflatelymeneuroborreliosis
AT marinazaretskaya acaseofchronicprogressivelymeencephalitisasamanifestationoflatelymeneuroborreliosis
AT mohamedhyassin acaseofchronicprogressivelymeencephalitisasamanifestationoflatelymeneuroborreliosis
AT vivekverma caseofchronicprogressivelymeencephalitisasamanifestationoflatelymeneuroborreliosis
AT matthewroman caseofchronicprogressivelymeencephalitisasamanifestationoflatelymeneuroborreliosis
AT dishashah caseofchronicprogressivelymeencephalitisasamanifestationoflatelymeneuroborreliosis
AT marinazaretskaya caseofchronicprogressivelymeencephalitisasamanifestationoflatelymeneuroborreliosis
AT mohamedhyassin caseofchronicprogressivelymeencephalitisasamanifestationoflatelymeneuroborreliosis
_version_ 1724355152842850304