[Therapy-resistant depression with fatigue. A case of presumed streptococcal-associated autoimmune disorder].
After a tick bite and erythema chronicum migrans, a 31-year-old patient developed headaches, fatigue, multilocular pain and therapy-resistant depression with cognitive disturbances. Antibodies against Borrelia and Borna disease virus, high antibody titers against streptococci at the point of most severe depression and blood-CSF barrier dysfunction were found. Streptococcal antibody titers were normal 2 years before and 4 years after. With penicillin treatment and tonsillectomy, therapy-resistant depression improved. We suggest that the whole syndrome was streptococcal-associated autoimmune disease.
Bechter
K
K
Abteilung Psychiatrie II, Bezirkskrankenhaus der Universität Ulm, Ludwig-Heilmeyer-Str. 2, 89312 Günzburg. Karl.Bechter@bkh-guenzburg.de
Bindl
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A
Horn
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Schreiner
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V
D000328:Adult; D001327:Autoimmune Diseases / Q000628:therapy*; D003863:Depression / Q000517:prevention & control*; D005221:Fatigue / Q000517:prevention & control*; D005260:Female; D006801:Humans; D010406:Penicillins / Q000627:therapeutic use*; D013290:Streptococcal Infections / Q000628:therapy*; D013577:Syndrome; D014068:Tonsillectomy; D017211:Treatment Failure
D010406:Penicillins