Neuroretinitis as a manifestation of Lyme disease in South India: a case report.
OBJECTIVE
To report a rare case of Lyme disease with neuroretinitis from South India.


METHODS
Retrospective case report. A 45-year-old lady who hails from the Nagarhole forest in South India presented with a history of tick bite followed by diminution of vision in the left eye. Fundus evaluation of the left eye showed neuroretinitis. Mantoux test, Treponema pallidum hemagglutination test, serum angiotensin converting enzyme, and ELISA for toxoplasmosis and rickettsial infections were negative. ELISA for Lyme disease was positive for IgM antibodies. This was confirmed by Western blot test.


RESULTS
Ocular inflammation resolved with a course of doxycyline and oral steroids. The species of the tick was also identified.


CONCLUSIONS
This case highlights the need to consider Lyme disease, though rare in India, in the differential diagnosis of neuroretinitis especially if the patient hails from a forest area.
Babu
Kalpana
K
Vittala International Institute of Ophthalmology & Prabha Eye Clinic and Research Center, Bangalore, India. kb_7375@yahoo.co.in
Murthy
Praveen R
PR
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000818:Animals; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000276:immunology; D007194:India; D008193:Lyme Disease / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008875:Middle Aged; D012173:Retinitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D013987:Ticks
D000305:Adrenal Cortex Hormones; D007075:Immunoglobulin M; D004318:Doxycycline