Division of Pediatric Neurology, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh 249203 India.
Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh 249203, India.
J Trop Pediatr. 2021 Jan 29;67(1). doi: 10.1093/tropej/fmaa067.
Primary neuroleptospirosis although rare but has been reported in the literature in the form of case reports and case series. However, there are no reports of autoimmune encephalitis triggered by leptospirosis in the literature, although four cases of acute disseminated encephalomyelitis, which is also considered to have autoimmune etiology have been reported. We are reporting an adolescent girl, who developed anti-N-methyl-d-aspartate receptor encephalitis after the resolution of systemic symptoms of leptospirosis. Her symptoms including neuropsychiatric and extrapyramidal features and sleep disturbances resolved completely after immunotherapy. As recently autoimmune encephalitis triggered by various infections are getting reported more frequently around the world, the clinicians need to consider this clinical possibility, even in patients with leptospirosis, who develop neurological symptoms while systemic clinical features are subsiding. Early recognition and timely administration of immunotherapy have the potential to completely reverse the neurological symptoms.
原发性神经莱姆病虽然罕见，但已有文献报道为病例报告和病例系列。然而，文献中没有莱姆病引发自身免疫性脑炎的报道，尽管有四起急性播散性脑脊髓炎的报道，该病也被认为具有自身免疫病因。我们报告了一名青少年女孩，在莱姆病全身症状消退后，发生了抗 N-甲基-D-天冬氨酸受体脑炎。她的症状包括神经精神和锥体外系特征以及睡眠障碍，在免疫治疗后完全缓解。由于最近世界各地越来越多地报道各种感染引发的自身免疫性脑炎，临床医生需要考虑这种临床可能性，即使是在莱姆病患者中，当全身临床特征消退时，也会出现神经系统症状。早期识别和及时给予免疫治疗有可能完全逆转神经系统症状。
