An Unusual Presentation of Encephalitis in a Patient with Lyme Neuroborreliosis

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Authors

  • Maithily Patel West Virginia University (WVU),Wheeling Hospital,Wheeling,WV 26003, USA
  • Jazmin Jatana West Virginia University (WVU),Wheeling Hospital,Wheeling,WV 26003, USA
  • Ramya Ramesh West Virginia University (WVU),Wheeling Hospital,Wheeling,WV 26003, USA
  • Milind Awale West Virginia University (WVU),Wheeling Hospital,Wheeling,WV 26003, USA

DOI:

https://doi.org/10.17140/imoj-8-123

Keywords:

Lyme disease, Lyme neuroborreliosis, Encephalitis, Bell’s palsy, Neurological manifestations, Infectious diseases, Borrelia burgdorferi, Lumbar puncture

Abstract

Lyme disease is the most common vector-borne disease in the United States. With a rate of 100.14 new cases per 100,000 residents in 2021, West Virginia has one of the highest Lyme disease incidence rates in the nation. Lyme encephalitis presents a significant challenge in clinical diagnosis and management. This case report and limited literature review provides clinicians and researchers with valuable insight into clinical approaches, diagnostic tools, and available treatment strategies. Informed consent was obtained from the patient. This report and discussion highlights the importance of combining clinical, serological, and other diagnostic tools to improve the accuracy of Lyme encephalitis diagnosis.

References

Centers for Disease Control and Prevention (CDC). Lyme dis-ease--United States, 2001-2002. MMWR Morb Mortal Wkly Rep. 2004; 53(17): 365-369. Submit your article to this journal |https://openventio.org/online-manuscript-submission-system/ Case Report | Volume 8 | Number 1 | Patel M, et al

Halperin JJ, Volkman DJ, Wu P. Central nervous system abnor-malities in Lyme neuroborreliosis. Neurology. 1991; 41(10): 1571- 1582. doi: 10.1212/wnl.41.10.1571

Logigian EL, Kaplan RF, Steere AC. Chronic neurologic mani-festations of Lyme disease. N Engl J Med. 1990; 323(21): 1438- 1444. doi: 10.1056/NEJM199011223232102

Beuchat I, Dunet V, Meylan P, Du Pasquier R. Late Lyme neu-roborreliosis with chronic encephalomyelitis. Neurology. 2018; 91(13): 627-628. doi: 10.1212/WNL.0000000000006252

Knudtzen FC, Eikeland R, Bremell D, et al. Lyme neuroborreli-osis with encephalitis: A systematic literature review and a Scandi-navian cohort study. Clin Microbiol Infect. 2022; 28(5): 649-656. doi: 10.1016/j.cmi.2021.11.001

Ogrinc K, Lusa L, Lotrič-Furlan S, et al. Course and outcome of early European lyme neuroborreliosis (Bannwarth Syndrome): Clinical and laboratory findings. Clin Infect Dis. 2016; 63(3): 346- 353. doi: 10.1093/cid/ciw299

Bakker R, Aarts MCJ, van der Heijden GJMG, Rovers MM. No evidence for the diagnostic value of borrelia serology in patients with sudden hearing loss. Otolaryngology–Head and Neck Surgery. 2012; 146(4): 539-543. doi: 10.1177/0194599811432535

Bremell D, Dotevall L. Oral doxycycline for Lyme neurobor-reliosis with symptoms of encephalitis, myelitis, vasculitis or in-tracranial hypertension. Eur J Neurol. 2014; 21(9): 1162-1167. doi: 10.1111/ene.12420

Karlsson M, Hammers-Berggren S, Lindquist L, Stiernstedt G, Svenungsson B. Comparison of intravenous penicillin G and oral doxycycline for treatment of Lyme neuroborreliosis. Neurology. 1994; 44(7): 1203-1207. doi: 10.1212/wnl.44.7.1203

Rosendahl SB, Ravn P, Lebech A-M, Stenør CPM. Lyme neu-roborreliosis with encephalitis: A rare case. IDCases. 2023; 31: e01704. doi: 10.1016/j.idcr.2023.e01704

Benatar M, Edlow J. The spectrum of cranial neuropathy in pa-tients with Bell's palsy. Arch Intern Med. 2004; 164(21): 2383-2385. doi: 10.1001/archinte.164.21.2383

Schmidt C, Plate A, Angele B, et al. A prospective study on the role of CXCL13 in Lyme neuroborreliosis. Neurology. 2011; 76(12): 1051-1058. doi: 10.1212/WNL.0b013e318211c39a

Kortela E, Kanerva MJ, Puustinen J, et al. Oral doxycycline com-pared to intravenous ceftriaxone in the treatment of lyme neurobor-reliosis: A multicenter, equivalence, randomized, open-label trial. Clin Infect Dis. 2021; 72(8): 1323-1331. doi: 10.1093/cid/ciaa217

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Published

2024-04-23

How to Cite

Maithily Patel, Jazmin Jatana, Ramya Ramesh, & Milind Awale. (2024). An Unusual Presentation of Encephalitis in a Patient with Lyme Neuroborreliosis. Internal Medicine, 8(1), 1–3. https://doi.org/10.17140/imoj-8-123