Rodríguez-Romero E, Elizalde-Hernández PD, Gracia-Reyes C, Miralrío GG

Language: Spanish
References: 13
Page: 121-128
PDF size: 204.09 Kb.

ABSTRACT

Introduction: Lyme disease is caused by Borrelia burgdorferi. Bannwarth’s syndrome is one of the early neurological manifestations of the disease characterized by lymphocytic meningitis with radiculopathy.
Case report: A 30-year-old man came to the hospital because of lower extremity paresthesias, arthralgias, myalgias, and dysarthria. In the neurological examination we identified dysarthria, impairment of cranial nerves VII, IX, X, XI and XII, decreased strength in all four extremities, generalized hyporeflexia and hypotonia, and indifferent bilateral plantar response. CSF (cerebrospinal fluid) was reported with 300 cells, 90% of mononuclear, protein 257 mg/dl. The nerve conduction tests reported widespread axonal radiculoneuropathy. Viral panel was performed reagent for HIV to be reported. The PCR (polymerase chain reaction) for tuberculosis and cytomegalovirus were negative in CSF. Cultures for bacteria, fungi and mycobacteria were negative. VDRL and treponemal antibodies were negative. Neuroborreliosis was suspected so we requested Western Blot IgG against Borrelia burgdorferi sensu lato which was positive in CSF. Treatment was initiated with ceftriaxone presenting gradual improvement.
Conclusion: Lyme neuroborreliosis in patients with HIV infection is apparently unrelated to immune status, nor with the clinical presentation of the disease. In Mexico, it is necessary to consider the disease in the presence of suggestive clinical manifestations.

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