Panuveitis Caused by Borrelia Burgdorferi Sensu Lato Infection

Abstract

A 13-year-old boy who presented with a red left eye, painful eye movement, blurred vision, photophobia and increased lacrimation, was diagnosed with 1-sided panuveitis with optic disk edema. Diagnostic work-up revealed borrelial antibodies in serum. Diagnosis of Lyme borreliosis was substantiated by demonstration of lymphocytic pleocytosis, intrathecal borrelial antibody synthesis, improvement after treatment with ceftriaxone and exclusion of other causes.

Lyme borreliosis and other tick-borne diseases. Guidelines from the French scientific societies

“…As most reports are based on serological findings, imputability of ophthalmologic manifestations to Lyme borreliosis cannot be ascertained. Very few reports documented Borrelia burgdorferi tropism for the eye with positive PCR in ocular tissue samples or with ophthalmologic manifestations (uveitis) concomitant to Lyme neuroborreliosis confirmed by CSF analysis [41][42][43] (grade B).…”

Panuveítis asociada a la enfermedad de Lyme en un paciente colombiano.

“…La principal causa de esta en Colombia es la infección por el Toxoplasma gondii, sin embargo, suele tratarse de un cuadro unilateral de aspecto granulomatoso diferente a la presentación del paciente (10) . Existen otras causas de la panuveítis autoinmune o infecciosa en nuestro medio, como la sarcoidosis, el síndrome de Behcet, la enfermedad de Vogt-Koyanagi-Harada y la tuberculosis, que deben descartarse antes de pensar en diagnósticos atípicos en Colombia como la enfermedad de Lyme (11) .…”

“…La detección de anticuerpos IgG o IgM por ELISA (enzyme-linked immunosorbent assay) o por IFA (indirect immunofluorescent assay), es el método de elección para pacientes con sospecha diagnóstica que presenten síntomas sugestivos (9) . Los resultados dudosos o positivos se deben confirmar por la técnica Western blot.…”

Lyme-associated uveitis: Clinical spectrum and review of literature

“…The evolution after antibiotherapy was good for all patients, but with a more rapid and complete amelioration for the acute group. 15 Many one-or two-patient case reports over the world describe all types of Lyme-associated uveitis [18][19][20][21][22][23][24][31][32][33][34] (n = 13): anterior (n = 5), intermediate (n = 2), posterior or panuveitis (n = 5), and endophthalmitis (n = 1). This last patient first presented with severe panuveitis that worsened with cortisone treatment, requiring two vitrectomies that brought back intact spirochetes from the vitreous material.…”

“…After a ceftriaxone treatment, visual acuity increased from 6/30 to 6/6 and without recurrence of inflammation. The average follow-up was 18.4 months (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). The main problems that persisted after treatment were inflammatory recurrences as described above (n = 4), epiretinal membrane (n = 3), cataracts (n = 2), pigmentary epithelium atrophy (n = 1), and chronic hyalitis (n = 1).…”