Shiokawa T, Hasegawa M, Yamazaki M, Ikota T, Sato N
Department of Internal Medicine, Kin-ikyo Sapporo Okadama Hospital.
Rinsho Shinkeigaku. 1991 May;31(5):561-3.
A 40-year-old man developed progressive neurologic manifestations following a tick bite with subsequent localized erythema migrans. These manifestations included bilateral sensory radiculoneuritis (T7-12), rectovesical dysfunction, paraparesis, right facial palsy and nuchal rigidity. Both serum and cerebrospinal fluid titers of IgG antibody against Borrelia burgdorferi were 1:8,192 using indirect immunofluorescence assay. No IgM antibody was detected. With high-dose intravenous penicillin and corticosteroid treatment the neurologic symptoms and signs gradually subsided, with a corresponding decrease in the IgG antibody titers. Among the cases of Lyme disease reported so far in Japan, the present case seems to be typical and serious in terms of the severity of nervous system involvement and the intensity of the antibody response.
一名40岁男性在被蜱叮咬后出现游走性红斑，随后出现进行性神经学表现。这些表现包括双侧感觉性神经根神经炎（T7 - 12）、直肠膀胱功能障碍、截瘫、右侧面神经麻痹和颈部强直。采用间接免疫荧光法检测，血清和脑脊液中抗伯氏疏螺旋体IgG抗体滴度均为1:8,192。未检测到IgM抗体。经大剂量静脉注射青霉素和皮质类固醇治疗后，神经症状和体征逐渐消退，IgG抗体滴度相应降低。在日本迄今为止报告的莱姆病病例中，就神经系统受累的严重程度和抗体反应的强度而言，本病例似乎具有典型性且较为严重。
