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[A Japanese case of neuroborreliosis with papillitis].
Rinsho Shinkeigaku. 2015; 55(4):248-53.RS

Abstract

A 53-year-old Japanese female developed a fever about two months after a tick bite. She also exhibited blurred vision, central scotoma in the left eye, left facial paresis and mild ataxia. A fundus examination revealed left disc swelling in the left eye. An ophthalmological examination showed decreased visual acuity with central scotoma in the left eye. We suspected neuroborreliosis because of the presence of pleocytosis and an elevated level of IL-6 in the cerebrospinal fluid (CSF), in addition to the characteristic neurological findings. She was positive for serum IgG antibodies against Borrelia by a Western blot of her serum. Therefore, we diagnosed her to have neuroborreliosis with papillitis. After the combined administration of antibiotics and steroids, her symptoms gradually improved, but not all of her eye manifestations resolved. Although ocular involvement is rare in neuroborreliosis, this case highlights the fact that neuroborreliosis shoud be considered as a differential diagnosis for patients presenting with papillitis. The diagnosis of neuroborreliosis is important since improvement of the visual acuity is possible with specific antibiotheraphy. In cases with papillitis of unknown etiology, it might be better to consider the possibility of neuroborreliosis should be considered when there are signs of Lyme borreliosis, such as facial nerve palsy, arthritis or radiculoneuritis.

Authors+Show Affiliations

Department of Neurology, National Hospital Organization Beppu Medical Center.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

jpn

PubMed ID

25904254

Citation

Kouge, Junpei, et al. "[A Japanese Case of Neuroborreliosis With Papillitis]." Rinsho Shinkeigaku = Clinical Neurology, vol. 55, no. 4, 2015, pp. 248-53.
Kouge J, Hayashida S, Imaki H, et al. [A Japanese case of neuroborreliosis with papillitis]. Rinsho Shinkeigaku. 2015;55(4):248-53.
Kouge, J., Hayashida, S., Imaki, H., & Mitsuo, K. (2015). [A Japanese case of neuroborreliosis with papillitis]. Rinsho Shinkeigaku = Clinical Neurology, 55(4), 248-53. https://doi.org/10.5692/clinicalneurol.55.248
Kouge J, et al. [A Japanese Case of Neuroborreliosis With Papillitis]. Rinsho Shinkeigaku. 2015;55(4):248-53. PubMed PMID: 25904254.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [A Japanese case of neuroborreliosis with papillitis]. AU - Kouge,Junpei, AU - Hayashida,Shotaro, AU - Imaki,Hiroyuki, AU - Mitsuo,Kunihiko, PY - 2015/4/24/entrez PY - 2015/4/24/pubmed PY - 2016/9/2/medline SP - 248 EP - 53 JF - Rinsho shinkeigaku = Clinical neurology JO - Rinsho Shinkeigaku VL - 55 IS - 4 N2 - A 53-year-old Japanese female developed a fever about two months after a tick bite. She also exhibited blurred vision, central scotoma in the left eye, left facial paresis and mild ataxia. A fundus examination revealed left disc swelling in the left eye. An ophthalmological examination showed decreased visual acuity with central scotoma in the left eye. We suspected neuroborreliosis because of the presence of pleocytosis and an elevated level of IL-6 in the cerebrospinal fluid (CSF), in addition to the characteristic neurological findings. She was positive for serum IgG antibodies against Borrelia by a Western blot of her serum. Therefore, we diagnosed her to have neuroborreliosis with papillitis. After the combined administration of antibiotics and steroids, her symptoms gradually improved, but not all of her eye manifestations resolved. Although ocular involvement is rare in neuroborreliosis, this case highlights the fact that neuroborreliosis shoud be considered as a differential diagnosis for patients presenting with papillitis. The diagnosis of neuroborreliosis is important since improvement of the visual acuity is possible with specific antibiotheraphy. In cases with papillitis of unknown etiology, it might be better to consider the possibility of neuroborreliosis should be considered when there are signs of Lyme borreliosis, such as facial nerve palsy, arthritis or radiculoneuritis. SN - 1882-0654 UR - https://www.unboundmedicine.com/medline/citation/25904254/[A_Japanese_case_of_neuroborreliosis_with_papillitis]_ L2 - https://dx.doi.org/10.5692/clinicalneurol.55.248 DB - PRIME DP - Unbound Medicine ER -