[Meningopapillitis disclosing Lyme disease].
A 65 old year woman was admitted to the hospital for a low back pain, a fever and an elevated sedimentation rate. Four months later she noted a progressive visual loss first affected the right eye (visual acuity: 6/10) and then the left (visual acuity : 6/10). Fundus examination showed a bilateral papilledema. CT Scan and MRI were normal. A lumbar puncture disclosed a lymphocytic pleocytosis (68 leukocytes/mm3), an increase in protein level (1,9 g/l) and oligoclonal bands. A serologic test for B. Burgdorferi was positive both in blood (1/64 degrees) and in cerebrospinal fluid (> or = 1/128). The patient was treated with intravenous ceftriaxone 2 g daily for 2 weeks. Fifteen days later the low back pain had disappeared and the CSF cellular count had decreased to 20 leukocytes/mm3. Seven months later, CSF was normal (2 leukocytes/mm3, protein level: 0.65 g/l.); Titer against B. Burgdorferi had improved to 1/160 in serum and 1/16 in CSF; visual acuity had improved to 8/10 on left, and was the same on right.
Gérard
P
P
Service de Neurologie, CHU Amiens.
Canaple
S
S
Rosa
A
A
D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008193:Lyme Disease / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016920:Meningitis, Bacterial / Q000188:drug therapy / Q000209:etiology*; D010211:Papilledema / Q000188:drug therapy / Q000209:etiology*; D010406:Penicillins / Q000627:therapeutic use
D002511:Cephalosporins; D010406:Penicillins; D002443:Ceftriaxone; D000658:Amoxicillin