Unusual Presentation of Unilateral Isolated Probable Lyme Optic Neuritis

Burakgazi, Ahmet Z.; Henderson, Carl S.

doi:10.1155/2016/7471842

“…Follow-up appointments should aim to confirm treatment response and check for posttreatment Lyme disease syndrome (PTLDS), which is described as total or partial recovery from the manifestations of Lyme disease after treatment followed by persistent or relapsing nonspecific symptoms, usually starting more than six months after completion of the antibiotic therapy [6]. Those symptoms are fatigue, myalgias, sleep disturbances, headache, and arthralgia.…”

Section: Discussionmentioning

confidence: 99%

“…Optic neuritis is an inflammation of the optic nerve resulting in blurred vision, eye pain, a central visual field defect, dyschromatopsia, and a relative afferent pupillary defect. It is common in autoimmune, inflammatory, and infectious diseases of the central nervous system (CNS) but its association with Lyme disease is poorly understood [6]. Few cases of optic neuritis due to borreliosis have been published in the literature.…”

Section: Introductionmentioning

confidence: 99%

A Rare Cause of Optic Neuropathy

Cruz

¹

,

Pereira

²

,

Vieira

³

et al. 2020

Cureus

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Lyme disease is a multisystem infection caused by Borrelia burgdorferi that mainly affects the joints, the heart, and the nervous system. Neurological complications usually manifest in untreated patients and present as meningitis, cranial neuropathies, and radiculoneuritis. The authors present the case of a 48-year-old male who developed loss of vision in the right eye over a period of two months. On physical examination a relative afferent pupillary defect of the right eye was noted. Visual evoked potential test revealed delayed P100 latency bilaterally, confirming a bilateral optic neuropathy. The analysis of the cerebrospinal fluid (CSF) showed a lymphocytic meningitis. After an extensive work-up, a diagnosis of Lyme neuroborreliosis with meningitis and optic neuritis was made. The patient was treated with antibiotics and showed gradual improvement. The follow-up brain MRI revealed a mild T2 hyperintensity on the right optic nerve with gliosis, sequelae of the inflammatory process. Lyme disease should always be considered in patients from endemic areas with nonspecific symptoms. The diagnosis of neuroborreliosis is challenging, but prompt identification and treatment can prevent the development of complications and sequelae.

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“…Optic neuritis has not been reported among patients infected with B. miyamotoi so far and is described as a rare syndrome in the course of Lyme disease [26,27,28]. However, the results from a study conducted by Platonov et al [29]…”

Section: Discussionmentioning

confidence: 99%

Borrelia miyamotoi DNA in a patient suspected of Lyme borreliosis

Fiecek

¹

,

Lewandowska

²

,

Roguska

³

et al. 2019

Preprint

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Background Clinical manifestations in infection caused by B. miyamotoi can mimick highly variable symptoms of Lyme disease. The aim of our studies was to detect DNA of B. miyamotoi spirochetes in clinical materials from patients suspected of neuroborreliosis(retrospectively).Methods Samples of blood serum and cerebrospinal fluid were collected from 133 patients with clinical manifestations of neuroborreliosis. Diagnosis was established by detection of IgM and / or IgG specific antibodies to B. burgdorferi with ELISA in both sera and CSF. Specificity of positive ELISA results in sera were confirmed with Western-blot test. Bacterial DNA from the collected material was extracted, amplified and sequenced.Results Among 133 patients with clinical manifestations of neuroborreliosis recognized in the years 2010-2018., DNA of B. miyamotoi was detected in CSF from 1 (0.8%) patient with extraocular optic neuritis of the left eye (GenBank accession No. MK674170 and MK674171).Conclusion Detection of B. miyamotoi in patients with central nervous system infections, will allow a better understanding of the epidemiology of infections caused by Borrelia sp. spirochetes. Patients with neurological symptoms and questionable serological findings are a serious diagnostic problem, due to failure to meet the criteria for neuroboreliosis. This indicates the need for further studies of patients with signs of CNS infection.

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“…The main criterion for inclusion to the studies was the detection of neurological symptoms resembling Optic neuritis has not been reported among patients infected with B. miyamotoi so far and is described as a rare syndrome in the course of Lyme disease [17,18,19]. However, the results from a study conducted by Platonov et al [20]…”

Section: Methodsmentioning

confidence: 99%

Borrelia miyamotoi DNA in a patient suspected of Lyme borreliosis

Fiecek

¹

,

Lewandowska

²

,

Roguska

³

et al. 2019

Preprint

View full text Add to dashboard Cite

Background Clinical manifestations in infection caused by B. miyamotoi can mimick highly variable symptoms of Lyme disease. The aim of our studies was to detect DNA of B. miyamotoi spirochetes in clinical materials from patients suspected of neuroborreliosis(retrospectively).Methods Samples of blood serum and cerebrospinal fluid were collected from 133 patients with clinical manifestations of neuroborreliosis. Diagnosis was established by detection of IgM and / or IgG specific antibodies to B. burgdorferi with ELISA in both sera and CSF. Specificity of positive ELISA results in sera were confirmed with Western-blot test. Bacterial DNA from the collected material was extracted, amplified and sequenced.Results Among 133 patients with clinical manifestations of neuroborreliosis recognized in the years 2010-2018., DNA of B. miyamotoi was detected in CSF from 1 (0.8%) patient with extraocular optic neuritis of the left eye (GenBank accession No. MK674170 and MK674171).Conclusion Detection of B. miyamotoi in patients with central nervous system infections, will allow a better understanding of the epidemiology of infections caused by Borrelia sp. spirochetes. Patients with neurological symptoms and questionable serological findings are a serious diagnostic problem, due to failure to meet the criteria for neuroboreliosis. This indicates the need for further studies of patients with signs of CNS infection.

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Unusual Presentation of Unilateral Isolated Probable Lyme Optic Neuritis

Cited by 10 publications

References 24 publications

A Rare Cause of Optic Neuropathy

A Rare Cause of Optic Neuropathy

Borrelia miyamotoi DNA in a patient suspected of Lyme borreliosis

Borrelia miyamotoi DNA in a patient suspected of Lyme borreliosis

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