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Case Report

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

1
Department of Medicine, University of Pittsburgh Medical Center, PA, USA
2
Division of Neurology, University of Pittsburgh Medical Center, PA, USA
3
Division of Infectious Diseases, University of Pittsburgh Medical Center, PA, USA
*
Author to whom correspondence should be addressed.
Infect. Dis. Rep. 2014, 6(4), 5496; https://doi.org/10.4081/idr.2014.5496
Submission received: 21 July 2014 / Revised: 30 September 2014 / Accepted: 30 September 2014 / Published: 11 December 2014

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.
Keywords: Lyme neuroborreliosis; Borrelia burgdorferi; encephalopathy Lyme neuroborreliosis; Borrelia burgdorferi; encephalopathy

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MDPI and ACS Style

Verma, V.; Roman, M.; Shah, D.; Zaretskaya, M.; Yassin, M.H. A case of chronic progressive Lyme encephalitis as a manifestation of late Lyme neuroborreliosis. Infect. Dis. Rep. 2014, 6, 5496. https://doi.org/10.4081/idr.2014.5496

AMA Style

Verma V, Roman M, Shah D, Zaretskaya M, Yassin MH. A case of chronic progressive Lyme encephalitis as a manifestation of late Lyme neuroborreliosis. Infectious Disease Reports. 2014; 6(4):5496. https://doi.org/10.4081/idr.2014.5496

Chicago/Turabian Style

Verma, Vivek, Matthew Roman, Disha Shah, Marina Zaretskaya, and Mohamed H. Yassin. 2014. "A case of chronic progressive Lyme encephalitis as a manifestation of late Lyme neuroborreliosis" Infectious Disease Reports 6, no. 4: 5496. https://doi.org/10.4081/idr.2014.5496

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