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...
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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 |
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