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

Verma, V and Roman, M and Shah, D and Zaretskaya, M and Yassin, MH (2014) A case of chronic progressive Lyme encephalitis as a manifestation of late Lyme neuroborreliosis. Infectious Disease Reports, 6 (4). 51 - 54.

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Abstract

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.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Verma, V
Roman, M
Shah, D
Zaretskaya, M
Yassin, MHMHY8@pitt.eduMHY8
Date: 1 January 2014
Date Type: Publication
Journal or Publication Title: Infectious Disease Reports
Volume: 6
Number: 4
Page Range: 51 - 54
DOI or Unique Handle: 10.4081/idr.2014.5496
Schools and Programs: School of Medicine > Infectious Diseases and Microbiology
School of Medicine > Medicine
School of Medicine > Neurology
Refereed: Yes
Date Deposited: 09 Apr 2015 20:28
Last Modified: 27 Mar 2021 10:55
URI: http://d-scholarship.pitt.edu/id/eprint/24690

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