Seronegative chronic relapsing neuroborreliosis.
We report an unusual patient with evidence of Borrelia burgdorferi infection who experienced repeated neurologic relapses despite aggressive antibiotic therapy. Each course of therapy was associated with a Jarisch-Herxheimer-like reaction. Although the patient never had detectable free antibodies to B. burgdorferi in serum or spinal fluid, the CSF was positive on multiple occasions for complexed anti-B. burgdorferi antibodies, B. burgdorferi nucleic acids and free antigen.
Lawrence
C
C
Department of Medicine, Albert Einstein College of Medicine, New York, N.Y., USA.
Lipton
R B
RB
Lowy
F D
FD
Coyle
P K
PK
D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000134:cerebrospinal fluid; D000937:Antigen-Antibody Reactions; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008193:Lyme Disease / Q000188:drug therapy / Q000276:immunology*; D008875:Middle Aged; D009422:Nervous System Diseases / Q000188:drug therapy / Q000276:immunology*; D012008:Recurrence
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial