title: Co-existance of toxoplasmosis and neuroborreliosis - a case report.
abstract: The 53-year-old woman was initially diagnosed with multiple sclerosis, despite the fact that she did not really meet the clinical criteria. Her only symptoms were clumsiness and weakness of the right extremities. Being a veterinary research worker she had been exposed to infectious material. In 1995, she was diagnosed with ELISA as having toxoplasmosis and treated as such. In 2002, after the infectious, flu-like disease, she revealed arthritis and drowsiness, also with memory and language impairment. The patient continued to have symptoms consistent with previously examined clumsiness. She was diagnosed with Lyme via ELISA and PCR, and treated. She made a full recovery from acute symptoms. After a few months, neurological and neuropsychological examinations were performed. On the background of mild cognitive decline apraxia and difficulties of attention were noted as the main problems. A apraxia of the right hand complicated the patient's life and depreciated her quality of life. The patient underwent MRI examination. FSE, FAST and FLAIR sequences were made. The MRI demonstrated the appearance of several small hyperintense lesions in the white matter of the left and right frontal and left parietal lobe. These lesions were typical of the post-inflammatory leucoencephalopathy. Additionally, a ring-shaped, low-intensity lesion in the posterior part of the left parietal lobe was noticed. The lesion was 8 mm in diameter and described to be an old toxoplasmosis lesion. The patient had been treated and the symptoms consistent with Lyme disease resolved. Patient continues to have symptoms consistent with focal destruction of the parietal lobe. Over the past six months, she has not progressed and relapsed in a manner that is consistent with MS.
authors.affiliation: Department of Neurodegenerative Diseases, Institute of Agricultural Medicine, Jaczewskiego 2, 20-090 Lublin, Poland. kasiagu@yahoo.ca
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Gustaw
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Bełtowska
authors.forename: Edyta
authors.initials: E
authors.lastname: Długosz
mesh_terms: D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D020852:Lyme Neuroborreliosis / Q000150:complications* / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis; D010296:Parietal Lobe / Q000473:pathology*; D016133:Polymerase Chain Reaction; D016781:Toxoplasmosis, Cerebral / Q000150:complications* / Q000175:diagnosis*