title: Neuroretinitis as a manifestation of Lyme disease in South India: a case report.
abstract: 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.
authors.affiliation: Vittala International Institute of Ophthalmology & Prabha Eye Clinic and Research Center, Bangalore, India. kb_7375@yahoo.co.in
authors.forename: Kalpana
authors.initials: K
authors.lastname: Babu
authors.forename: Praveen R
authors.initials: PR
authors.lastname: Murthy
mesh_terms: 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
chemical_list: D000305:Adrenal Cortex Hormones; D007075:Immunoglobulin M; D004318:Doxycycline