title: [Comatose state--think different].
abstract: We report the case of a 76-year old woman, who presented with signs of a meningoencephalitis. The result of lumbar puncture showed a mononuclear pleocytosis. Empirical antimicrobial treatment was promptly initiated. Nevertheless a comatose state complicated the clinical course. The diagnosis of neuroborreliosis was made serologically and by molecular biology. Under adequate therapy with intravenous ceftriaxone the patient showed a slow but full recovery. This case illustrates that potentially reversible diseases need very careful decision making regarding therapeutic activities and that neuroborreliosis is a potentially reversible cause of severe neurologic impairment.
authors.affiliation: Medizinische Poliklinik, Universitätsspital Basel, Switzerland. aholbro@uhbs.ch
authors.forename: A
authors.initials: A
authors.lastname: Holbro
authors.forename: A
authors.initials: A
authors.lastname: Conen
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002443:Ceftriaxone / Q000008:administration & dosage; D003128:Coma / Q000188:drug therapy / Q000209:etiology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D020852:Lyme Neuroborreliosis / Q000175:diagnosis* / Q000188:drug therapy; D008218:Lymphocytosis / Q000188:drug therapy / Q000209:etiology*; D008581:Meningitis / Q000188:drug therapy / Q000209:etiology*; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone