Orbital myositis associated with Borrelia burgdorferi (Lyme disease) infection.
OBJECTIVE
To report on the clinical findings in a patient with isolated left inferior rectus myositis associated with serologically confirmed Borrelia burgdorferi infection.


METHODS
Interventional case report.


METHODS
Comprehensive clinical, laboratory, and imaging evaluation.


RESULTS
Contrast-enhanced computed tomography showed a swollen inferior rectus muscle with infraorbital soft tissue swelling in a patient with diplopia and prior symptoms consistent with manifestations of Lyme disease. Positive serum and cerebrospinal fluid antibodies to B. burgdorferi by enzyme-linked immunoassay were confirmed by Western blot, and the cerebrospinal fluid/serum antibody ratio was elevated. No alternative cause for orbital myositis was found, and treatment with antibiotics resulted in a complete recovery.


CONCLUSIONS
Orbital myositis should be added to the expanding list of ophthalmic manifestations of Lyme disease. Correct diagnosis and appropriate antibiotic therapy may reduce the likelihood of further neurologic or ophthalmologic sequelae.
Carvounis
Petros E
PE
Department of Ophthalmology, The George Washington University, Washington, DC 20037, USA.
Mehta
Ashu P
AP
Geist
Craig E
CE
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood / Q000134:cerebrospinal fluid; D015153:Blotting, Western; D025065:Borrelia burgdorferi / Q000276:immunology / Q000302:isolation & purification*; D002443:Ceftriaxone / Q000627:therapeutic use; D004172:Diplopia / Q000175:diagnosis; D004797:Enzyme-Linked Immunosorbent Assay; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008193:Lyme Disease / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D009801:Oculomotor Muscles / Q000473:pathology; D016727:Orbital Pseudotumor / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D002443:Ceftriaxone