Lyme disease: A case report with typical and atypical lesions

Sharma, Abha; Guleria, Sandesh; Sharma, Reena; Sharma, Anita

doi:10.4103/2229-5178.202271

Cited by 18 publications

(12 citation statements)

References 8 publications

(9 reference statements)

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“…Despite the limitations, our review provides several noteworthy observations that warrant additional awareness among researchers and clinicians in the region. Lyme disease, a tick-borne disease usually reported in Europe and North America [ 33 ], has seldom been reported in SA with only a few case reports found in the literature recently [ 34 – 36 ]. Praharaj et al reported a prevalence of 13% (65/500) of anti- Borrelia burgdorferi antibodies in a seroprevalence study conducted in 2008 in North-Eastern states of India bordering with China [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Non-malarial febrile illness: a systematic review of published aetiological studies and case reports from Southern Asia and South-eastern Asia, 1980–2015

Shrestha

Dahal

Ogbonnaa-Njoku

et al. 2020

BMC Med

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Background In the absence of definitive diagnosis, healthcare providers are likely to prescribe empirical antibacterials to those who test negative for malaria. This problem is of critical importance in Southern Asia (SA) and South-eastern Asia (SEA) where high levels of antimicrobial consumption and high prevalence of antimicrobial resistance have been reported. To improve management and guide further diagnostic test development, better understanding is needed of the true causative agents of fever and their geographical variability. Methods We conducted a systematic review of published literature (1980–2015) to characterise the spectrum of pathogens causing non-malarial febrile illness in SA and SEA. We searched six databases in English and French languages: MEDLINE, EMBASE, Global Health (CABI) database, WHO Global Health Library, PASCAL, and Bulletin de la Société Française de Parasitologie (BDSP). Selection criteria included reporting on an infection or infections with a confirmed diagnosis, defined as pathogens detected in or cultured from samples from normally sterile sites, or serological evidence of current or past infection. Results A total of 29,558 records from 19 countries in SA and SEA were screened, of which 2410 (8.1%) met the selection criteria. Bacterial aetiologies were reported in 1235 (51.2%) articles, viral in 846 (35.1%), parasitic in 132 (5.5%), and fungal in 54 (2.2%), and 143 (6.0%) articles reported more than one pathogen group. In descending order of frequency, Salmonella Typhi, Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, and coagulase negative Staphylococcus were the commonly reported bacteria, while dengue virus, chikungunya virus, Japanese encephalitis virus, hepatitis B virus, and hepatitis C virus were common viral pathogens reported. Reports of rarely reported or emerging pathogens included a case report of Borrelia burgdorferi (Lyme disease) in India in 2010 and reports of Nipah virus in Singapore and India. Conclusions This review summarises the reported non-malaria pathogens that may cause febrile illness in SA and SEA. The findings emphasise the need of standardising the reporting of aetiological studies to develop effective, evidence-based fever management and improved surveillance. Research and development of diagnostic tools would benefit from up-to-date epidemiological reporting of the regional diversities of non-malaria fever aetiologies. Trial registration PROSPERO registration, CRD42016049281

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Section: Discussionmentioning

confidence: 99%

Non-malarial febrile illness: a systematic review of published aetiological studies and case reports from Southern Asia and South-eastern Asia, 1980–2015

Shrestha

Dahal

Ogbonnaa-Njoku

et al. 2020

BMC Med

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“…Common ticks are found in northern Himalayan regions of India. Therefore tick borne lyme disease is not very uncommon supported by two articles published in two reputed journals of Dermatology [8,9].…”

Section: Discussionmentioning

confidence: 99%

Isolated bilateral facial palsy due to chicken pox- An unique presentation

Chatterjee¹,

Chatterjee²

2019

Int J Dermatol Clin Res

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A nineteen year old girl presented with lesions of chicken pox and inability to close both eyes properly for two days. She had diffi culty in eating and smiling. Vesicular non pruritic rashes were visible in various stages of healing over face and body except palm and soles. She complained of bilateral headaches but no vomiting, or weakness in her limbs or alteration of her taste sensation. She was alert and cooperative with normal speech and memory. B/L lower motor neuron type of facial nerve palsy was found. Routine blood work up, serology for HIV and Lyme disease, chest x ray, CSF study and MRI brain were normal. She was prescribed 60 mg of prednisolone and 4000 mg of acyclovir every day for 14days. She recovered completely from the neurodefi cit within 14 days.

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“…However, only a few studies have previously documented PTLDS [ 3, 13 ], while no cases of PTLDS have yet been described in the Asia. Although Borrelia burgdorferi is one of the most commonly reported vector-borne diseases in the USA and Europe, there have been very few reports in Asia [ 6, 7 ]. In India, only a handful of Lyme disease cases have been published [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although Borrelia burgdorferi is one of the most commonly reported vector-borne diseases in the USA and Europe, there have been very few reports in Asia [ 6, 7 ]. In India, only a handful of Lyme disease cases have been published [ 6 ]. EM is estimated to occur in 70 to 80 % of infected patients and is used to suspect Lyme disease [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

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First report of Lyme disease in Nepal

et al. 2018

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IntroductionLyme disease is a tick-borne illness caused by the spirochete Borrelia burgdorferi and is widely reported in the USA, Central Europe, South East Asia and Latin America. Until recently, no scientific report regarding Lyme disease in Nepal had been published.Case presentationA 32-year-old, previously healthy female visited the hospital with a history of joint pains, fatigue, neck stiffness, tingling sensation and headache. She was initially treated for typhoid fever, brucellosis and malaria, but did not show significant improvement. Doxycycline was prescribed empirically for 3 weeks for the treatment of suspected tick-borne illness. A two-tiered immunoglobulin laboratory testing confirmed Borrelia burgdorferi. She developed post-treatment Lyme disease syndrome after completion of antibiotic therapy.ConclusionTo the best of our knowledge, this is the first report of Lyme disease in Nepal and probably the first documented case of post-treatment Lyme disease syndrome in Asia. Lyme disease might have been overlooked in Nepal and, therefore, patients having clinical signs and symptoms similar to Lyme disease should not be disregarded in differential diagnosis.

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Lyme disease: A case report with typical and atypical lesions

Cited by 18 publications

References 8 publications

Non-malarial febrile illness: a systematic review of published aetiological studies and case reports from Southern Asia and South-eastern Asia, 1980–2015

Non-malarial febrile illness: a systematic review of published aetiological studies and case reports from Southern Asia and South-eastern Asia, 1980–2015

Isolated bilateral facial palsy due to chicken pox- An unique presentation

First report of Lyme disease in Nepal

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