title: Unilateral posterior stromal keratitis possibly secondary to Lyme disease.
abstract: OBJECTIVE
  To report a case of Lyme disease presenting as unilateral posterior stromal keratitis in a pediatric patient.
  
  
  METHODS
  Case report and review of available literature.
  
  
  RESULTS
  A 13-year-old adolescent with unilateral painless blurry vision presented with prominent posterior corneal stromal haze. A positive Borrelia burgdorferi antibody enzyme immunoassay and Western blot analysis (9 of 10 reactive immunoglobulin G bands and 1 of 3 immunoglobulin M bands) confirmed the diagnosis. Treatment with oral antibiotics and topical corticosteroids were necessary for resolution.
  
  
  CONCLUSIONS
  Lyme disease may present as a unilateral posterior stromal keratitis, even in a pediatric population. Treatment requires both systemic and topical therapy.
authors.affiliation: Krieger Eye Institute, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA. gwoldham@gmail.com
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Oldham
authors.forename: Gerami D
authors.initials: GD
authors.lastname: Seitzman
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D015153:Blotting, Western; D025065:Borrelia burgdorferi / Q000276:immunology*; D003319:Corneal Stroma / Q000473:pathology*; D004318:Doxycycline / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007124:Immunoenzyme Techniques; D007074:Immunoglobulin G / Q000276:immunology; D007075:Immunoglobulin M / Q000276:immunology; D007634:Keratitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008193:Lyme Disease / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D011239:Prednisolone / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D005938:Glucocorticoids; D007074:Immunoglobulin G; D007075:Immunoglobulin M; C009935:prednisolone acetate; D011239:Prednisolone; D004318:Doxycycline