Atypical papillitis: An isolated manifestation of Lyme disease

Lyme disease is a rare condition caused by the bacterium Borrelia burgdorferi. Despite typical symptoms including fever, headache, fatigue, and a characteristic skin rash, sometimes we cannot find those due to the lack of physician consultation in those early stages. If this disease is left untreated, infection could spread to the nervous system causing neuroborreliosis, an atypical and complicated manifestation of this disease. We present the case of an atypical papillitis, probably caused by this bacterium. We suspected this because of the results on the indirect test bloods and the improvement of the symptoms after treatment. This entity should be considered as a possible diagnosis of atypical optical neuropathies, particularly if it occurs in an endemic area.

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Comparative evaluation of three different ELISA methods for the diagnosis of early culture-confirmed Lyme disease in Italy

Journal of Medical Microbiology ◽

10.1099/jmm.0.45853-0 ◽

2005 ◽

Vol 54 (4) ◽

pp. 361-367 ◽

Cited By ~ 17

Author(s):

Antonella Marangoni ◽

Monica Sparacino ◽

Francesca Cavrini ◽

Elisa Storni ◽

Valeria Mondardini ◽

...

Keyword(s):

Immune Response ◽

Lyme Disease ◽

Borrelia Burgdorferi ◽

False Positive ◽

Comparative Evaluation ◽

Endemic Area ◽

Blood Donors ◽

Erythema Migrans ◽

Serum Samples ◽

Positive Reactivity

In this study the raising and development of the immune response to Borrelia burgdorferi infection in 45 Italian patients suffering from culture-confirmed Lyme borreliosis erythema migrans was investigated. A total of 95 serially collected serum samples were tested by using three different commercial ELISAs: recomWell Borrelia (Mikrogen), Enzygnost Borreliosis (DADE Behring) and Quick ELISA C6 Borrelia (Immunetics). The sensitivities of the ELISAs were as follows: Enzygnost Borreliosis IgM, 70.5 %; Quick ELISA C6 Borrelia, 62.1 %; recomWell Borrelia IgM, 55.7 %; recomWell Borrelia IgG, 57.9 %; and Enzygnost Borreliosis IgG, 36.8 %. In order to compare the specificity values of the three ELISAs, a panel of sera obtained from blood donors (210 samples coming from a non-endemic area and 24 samples from an endemic area) was tested, as well as sera from patients suffering from some of the most common biological conditions that could result in false-positive reactivity in Lyme disease serology (n = 40). RecomWell Borrelia IgG and recomWell Borrelia IgM were the most specific (97.1 % and 98.9 %, respectively), followed by Quick ELISA C6 Borrelia (96.7 %). Enzygnost Borreliosis IgG and IgM achieved 90.1 % and 92.3 % specificity, respectively. Sera that gave discrepant results when tested by the three ELISAs were further analysed by Western blotting.

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PARRY ROMBERG SYNDROME

Romanian Journal of Rheumatology ◽

10.37897/rjr.2016.4.7 ◽

2016 ◽

Vol 25 (4) ◽

pp. 209-211

Author(s):

Alexis-Virgil Cochino ◽

◽

Sigrid Covaci ◽

Oana-Maria Farkas ◽

◽

...

Keyword(s):

Nervous System ◽

Borrelia Burgdorferi ◽

Subcutaneous Tissue ◽

Rare Condition ◽

Localized Scleroderma ◽

Hemifacial Atrophy ◽

The Face ◽

Parry Romberg Syndrome ◽

Facial Hemiatrophy

Parry-Romberg syndrome, which is also known as progressive facial hemiatrophy, is a variant of localized scleroderma. This is a rare condition (OMIM # 141300), characterized by a progressive but self-limited atrophy of the skin and subcutaneous tissue on one side of the face. We present the case of a 9 year old boy with a typical presentation of hemifacial atrophy, with Borrelia burgdorferi infection without any changes of the nervous system.

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AWARENESS OF LYME BORRELIOSIS OF THE PATIENTS OF TERNOPIL REGIONAL TB DISPENSARY

International Journal of Medicine and Medical Research ◽

10.11603/ijmmr.2413-6077.2017.1.7810 ◽

2017 ◽

Author(s):

L. P. Melnyk ◽

L. A. Hryshchuk ◽

M. Koziol–Montewka ◽

P. S. Tabas ◽

R. O. Klos

Keyword(s):

Nervous System ◽

Lyme Disease ◽

Borrelia Burgdorferi ◽

Lyme Borreliosis ◽

Preventive Measures ◽

Epidemiological Data ◽

Sufficient Information ◽

Tick Bites ◽

The World ◽

History Of

Background. Lyme disease has many clinical features similar tothose in sarcoidosis and tuberculosis. Epidemiological data in the world, in particular in Ukraine, proves the increase in Lyme borreliosis incidence. Ternopil region is endemic with Lyme borreliosis.Objective. The research was aimed to investigate the prevalence of infection with Borrelia burgdorferi and epidemiology features of borreliosis among the patients of Ternopil Regional TB Dispensary.Methods. In total, 29 patients were admitted to Departments of Differential Diagnostic, TB Therapy and TB Surgery of Ternopil Regional TB Dispensary in October 2016-January 2017. All the surveyed answered the questions of an integrated international questionnaire, where they noted the area and a number of tick bites, described the removal method, noted the survey for borreliosis pathogen and complaints after tick bites.Results. It was established that 5 respondents had a history of tick bites episodes, but only in one case the patient was examined of borreliosis. Tick bites were noticed in 3 patients with sarcoidosis and 1 with tuberculosis (TB) and exudative pleurisy, respectively.Conclusions. The absence of appeals for medical care, lack of sufficient information on Lyme borreliosis and disuse of preventive measures for tick bites by the interviewed patients of Ternopil regional TB dispensary departments proves the need of improvement of health education on Lyme borreliosis (LB) among this category of population. 24 (82.7%) of 29 respondents did not remember the tick bite. The symptoms of (LB) are similar to those in sarcoidosis and tuberculosis (pleural lesions, heart, joints, nervous system, skin), and the presence of tick bites gives the reasons to examine these patients of Borrelia burgdorferi senso lato.

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Nervous System Lyme Disease

10.1093/med/9780199937837.003.0159 ◽

2017 ◽

Cited By ~ 1

Author(s):

John J. Halperin

Keyword(s):

Central Nervous System ◽

Cerebrospinal Fluid ◽

Nervous System ◽

Lyme Disease ◽

Borrelia Burgdorferi ◽

Clinical Manifestations ◽

Cerebrospinal Fluid Examination ◽

The Central Nervous System ◽

Cranial Neuropathies ◽

Lymphocytic Meningitis

Nervous system involvement occurs in 10% to 15% of patients infected with Borrelia burgdorferi, B. afzelii, or B. garinii, the tick-borne spirochetes responsible for Lyme disease and its European counterparts. Common clinical manifestations include lymphocytic meningitis, facial and other cranial neuropathies, and painful mononeuropathies such as Lyme radiculitis. Diagnosis requires appropriate clinical, epidemiological, and laboratory evidence. Appropriately interpreted serologic testing is highly reliable; cerebrospinal fluid examination is often informative if the central nervous system is involved. Several week courses of widely available oral or parenteral antimicrobials are curative in most patients.

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Isolated Cervical Myelitis in Lyme Disease: A Rare Manifestation of Acute Neuroborreliosis

Case Reports in Neurology ◽

10.1159/000508404 ◽

2020 ◽

Vol 12 (3) ◽

pp. 276-281

Author(s):

Maren Hieber ◽

Johann Lambeck ◽

Sebastian Rauer ◽

Juergen Bardutzky

Keyword(s):

Lyme Disease ◽

Borrelia Burgdorferi ◽

Clinical Symptoms ◽

Neurological Manifestation ◽

Imaging Findings ◽

Early Stages ◽

System Disease ◽

Rare Manifestation ◽

Strong Contrast

Neuroborreliosis is the neurological manifestation of Lyme disease, a tick-borne infectious multi-system disease caused by <i>Borrelia burgdorferi</i> sensu lato. It appears in 3 to 15% of all cases of acute Lyme disease, and includes meningitis, cranial neuritis, and painful radiculoneuritis as the most common manifestations. We report a case of acute neuroborreliosis that manifested as extended isolated cervical myelitis. Not only the manifestation as isolated myelitis in the early stages of borreliosis represents a rarity, but also the strong contrast between mild clinical symptoms and pronounced imaging findings in this case is remarkable.

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A Murine Model of Lyme Disease Demonstrates That Borrelia burgdorferi Colonizes the Dura Mater and Induces Inflammation in the Central Nervous System

10.1101/2020.04.24.060681 ◽

2020 ◽

Author(s):

Timothy Casselli ◽

Ali Divan ◽

Yvonne Tourand ◽

Heidi L. Pecoraro ◽

Catherine A. Brissette

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Lyme Disease ◽

Borrelia Burgdorferi ◽

Immune Responses ◽

Inflammatory Cytokines ◽

Dura Mater ◽

Brain Parenchyma ◽

The Central Nervous System ◽

Effective Models

ABSTRACTLyme disease, which is caused by infection with Borrelia burgdorferi and related species, can lead to inflammatory pathologies affecting the joints, heart, and nervous systems including the central nervous system (CNS). Inbred laboratory mice are effective models for characterizing B. burgdorferi infection kinetics and host immune responses in joints and heart tissues; however, similar studies are lacking in the CNS of these animals. Here we characterize the kinetics of B. burgdorferi colonization and associated immune responses in the CNS of infected C3H mice during early and subacute infection. B. burgdorferi colonized the dura mater following needle or tick challenge, and induced expression of inflammatory cytokines and a robust IFN response as well as histopathological changes. A sterile IFN response in the absence of B. burgdorferi or inflammatory cytokines was unique to the brain parenchyma, and could provide insights into the mechanism of inflammatory CNS pathology associated with this important pathogen.

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Neuroborreliosis – clinical presentation – Current state of knowledge

Przeglad Epidemiologiczny ◽

10.32394/pe.73.27 ◽

2019 ◽

pp. 321-328 ◽

Cited By ~ 1

Author(s):

Katarzyna Krawczuk ◽

Piotr Czupryna ◽

Sławomir Pancewicz ◽

Elżbieta Ołdak ◽

Monika Król ◽

...

Keyword(s):

Nervous System ◽

Lyme Disease ◽

Borrelia Burgdorferi ◽

Peripheral Nervous System ◽

Clinical Presentation ◽

Clinical Symptoms ◽

Clinical Course ◽

Tick Bites ◽

Current State ◽

Adults And Children

Neuroborreliosis is one of the manifestations of Lyme disease involving central and peripheral nervous system. It is caused by infection with Borrelia burgdorferi spirochete which is transmitted by tick bites. Neuroborreliosis can affect both adults and children. The clinical course in children is often different than in adults. The article discusses the most common clinical symptoms, complications, diagnostics and treatment of neuroborreliosis in children.

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Early Disseminated Lyme Disease with Carditis Complicated by Posttreatment Lyme Disease Syndrome

Case Reports in Infectious Diseases ◽

10.1155/2017/5847156 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4

Author(s):

Cheryl Novak ◽

Andrew Harrison ◽

John Aucott

Keyword(s):

Infectious Disease ◽

Nervous System ◽

Lyme Disease ◽

Borrelia Burgdorferi ◽

Cardiac Involvement ◽

Conduction System

Lyme disease is an infectious disease caused by the bacterium Borrelia burgdorferi. When untreated, infection may spread to the heart, nervous system, and joints. Cardiac involvement usually manifests as abnormalities of the conduction system and bradycardia. Treatment of Lyme disease is generally effective, with a subset of patients experiencing persistent, sometimes long-term symptoms called posttreatment Lyme disease syndrome.

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Evaluation of Selected Borrelia burgdorferi lp54 Plasmid-Encoded Gene Products Expressed during Mammalian Infection as Antigens To Improve Serodiagnostic Testing for Early Lyme Disease

Clinical and Vaccine Immunology ◽

10.1128/cvi.00399-15 ◽

2015 ◽

Vol 22 (11) ◽

pp. 1176-1186 ◽

Cited By ~ 6

Author(s):

Zachary P. Weiner ◽

Rebecca M. Crew ◽

Kevin S. Brandt ◽

Amy J. Ullmann ◽

Martin E. Schriefer ◽

...

Keyword(s):

Lyme Disease ◽

Borrelia Burgdorferi ◽

Recombinant Proteins ◽

Erythema Migrans ◽

Disease Patient ◽

Enzyme Linked Immunosorbent Assay ◽

Serum Samples ◽

Early Stages ◽

Lyme Carditis ◽

Mammalian Infection

ABSTRACTLaboratory testing for the diagnosis of Lyme disease is performed primarily by serologic assays and is accurate for detection beyond the acute stage of the infection. Serodiagnostic assays to detect the early stages of infection, however, are limited in their sensitivity, and improvement is warranted. We analyzed a series ofBorrelia burgdorferiproteins known to be induced within feeding ticks and/or during mammalian infection for their utility as serodiagnostic markers against a comprehensive panel of Lyme disease patient serum samples. The antigens were assayed for IgM and IgG reactivity in line immunoblots and separately by enzyme-linked immunosorbent assay (ELISA), with a focus on reactivity against early Lyme disease with erythema migrans (EM), early disseminated Lyme neuroborreliosis, and early Lyme carditis patient serum samples. By IgM immunoblotting, we found that recombinant proteins BBA65, BBA70, and BBA73 reacted with early Lyme EM samples at levels comparable to those of the OspC antigen used in the current IgM blotting criteria. Additionally, these proteins reacted with serum samples from patients with early neuroborreliosis and early carditis, suggesting value in detecting early stages of this disease progression. We also found serological reactivity against recombinant proteins BBA69 and BBA73 with early-Lyme-disease samples using IgG immunoblotting and ELISA. Significantly, some samples that had been scored negative by the Centers for Disease Control and Prevention-recommended 2-tiered testing algorithm demonstrated positive reactivity to one or more of the antigens by IgM/IgG immunoblot and ELISA. These results suggest that incorporating additionalin vivo-expressed antigens into the current IgM/IgG immunoblotting tier in a recombinant protein platform assay may improve the performance of early-Lyme-disease serologic testing.

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