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作者信息

Anadure R K, Saxena Rajeev, Sahu Samaresh, Kumar Ameet, Praveen L

机构信息

Professor & Senior Adviser (Medicine & Neurology), Command Hospital (Air Force), Bengaluru, India.

Senior Adviser (Medicine & Neurology), Command Hospital (Air Force), Bengaluru, India.

出版信息

Med J Armed Forces India. 2021 Jan;77(1):101-104. doi: 10.1016/j.mjafi.2019.02.010. Epub 2019 May 31.

Abstract

Lyme's disease also known as Erythema chronicum Migrans, is a multisystem infectious disease caused by the spirochete "Borrelia burgdorferi" which is transmitted by "Ixodes" tick, with both specific and nonspecific manifestations. Nervous system involvement occurs in 10%-15% of untreated patients and typically involves lymphocytic meningitis, cranial neuritis, and/or polyradiculitis. Here, we are reporting an interesting and challenging case of Neuro-Borreliosis in a young officer cadet, meeting the description for Bannwarth's syndrome and presenting initially as a surgical emergency followed by paraparesis. The diagnosis was finally clinched based on clinical profile of Chronic Myeloradiculopathy with focal myositis in the setting of recent outdoor camping, and confirmed by demonstrating high IgG antibody titres in serum and Cerebro spinal fluid (CSF). The officer cadet was treated successfully with a 6 week course of Ceftriaxone and Doxycycline, and went back to full training.

摘要

莱姆病也称为慢性游走性红斑,是一种由螺旋体“伯氏疏螺旋体”引起的多系统感染性疾病,通过“硬蜱”传播,有特异性和非特异性表现。10%至15%未经治疗的患者会出现神经系统受累,通常表现为淋巴细胞性脑膜炎、颅神经炎和/或多发性神经根炎。在此,我们报告一例年轻军校学员患神经型莱姆病的有趣且具有挑战性的病例,符合班沃思综合征的描述,最初表现为外科急症,随后出现双下肢轻瘫。最终根据近期户外露营情况下慢性脊髓神经根病伴局灶性肌炎的临床特征做出诊断,并通过血清和脑脊液(CSF)中高IgG抗体滴度得以证实。该军校学员接受了为期6周的头孢曲松和多西环素治疗,治疗成功,随后恢复了全面训练。

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Med J Armed Forces India. 2021 Jan;77(1):101-104. doi: 10.1016/j.mjafi.2019.02.010. Epub 2019 May 31.
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[Diagnosis of Lyme borreliosis].[莱姆病螺旋体病的诊断]
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Multiple cranial nerve involvement in Bannwarth's syndrome.班恩沃思综合征中的多组颅神经受累
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本文引用的文献

1
Borrelial lymphocytoma cutis: a diagnostic dilemma.皮肤型疏螺旋体淋巴细胞瘤:诊断难题。
Indian J Dermatol. 2014 Nov;59(6):595-7. doi: 10.4103/0019-5154.143530.
2
Treatment of Lyme borreliosis.莱姆病的治疗。
Arthritis Res Ther. 2009;11(6):258. doi: 10.1186/ar2853. Epub 2009 Dec 17.
3
Lumbosacral radiculopathy.腰骶神经根病
Neurol Clin. 2007 May;25(2):387-405. doi: 10.1016/j.ncl.2007.01.008.

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