Professional paper
BORELIOSIS AS A POTENTIAL MENTAL ILLNESS TRIGGER OR NEUROBORRELIOSIS? – a case report
Martina Dubravica
; Dom zdravlja Jaska
Nevenka Vinter-Repalust
; Ordinacija obiteljske medicine
Abstract
Lyme disease is the most common tick-borne disease. Neuroborreliosis (LNB) is the result of dissemination of Borrlia burgdorferi to the central
nervous system. Etiological diagnosis of LNB is mainly based on detection of specific intrathecal antibodies, which must be interpreted in the light of clinical symptoms and epidemiological evidence since symptoms may be extremely variable. If untreated this disease may result with a deleterious chronic condition. Family physicians have a
leading role in adequate prevention and education, especially in endemic areas, and should recognize or at least suspect the early stages of Lyme disease. Effective antibiotic treatment leads to LNB clinical
recovery with normalization in cerebrospinal pleocytosis. Serum and intrathecal antibodies often persist for a long period, and their routine
follow-up is not recommended. The 18 years old girl with symptoms of acute psychosis after unrecognised erythema migrans is presented. After
initial neurological and psychiatric examination and treatment in several institutions, the patient was referred for further evaluation of suspected
LNB to the university hospital. Despite her medical history, epidemiological data, clinical presentation and positive serology the diagnosis of LNB was excluded due to the absence of specific intrathecal
immunoglobulins, and the patient was treated as a decompensated psychosis.
Keywords
Lyme disease; neuroborreliosis; psychotic condition
Hrčak ID:
157246
URI
Publication date:
5.5.2016.
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