Weiler Nicholas S, Niendorf Eric, Dumic Igor
Research, Mayo Clinic Health Systems, Eau Claire, USA.
Radiology, Mayo Clinic, Eau Claire, USA.
Cureus. 2023 Jun 10;15(6):e40222. doi: 10.7759/cureus.40222. eCollection 2023 Jun.
Lyme disease (LD) is the most common tick-borne illness across the United States, caused by the bacterium and transmitted to humans by the bite of infected ticks. Jamestown Canyon Virus (JCV) is an emerging mosquito-borne pathogen found mostly in the upper Midwest and Northeastern United States. Co-infection between these two pathogens has not been previously reported since it would require the host to be bitten by the two infected vectors at the same time. We report a 36-year-old man who presented with erythema migrans and meningitis. While erythema migrans is a pathognomonic sign of early localized Lyme disease, Lyme meningitis does not occur in this stage but in the early disseminated stage. Furthermore, CSF tests were not supportive of neuroborreliosis, and the patient was ultimately diagnosed with JCV meningitis. We review JCV infection, LD, and this first reported co-infection to illustrate the complex interaction between different vectors and pathogens and to emphasize the importance of considering co-infection in people who live in vector-endemic areas.
莱姆病（LD）是美国最常见的蜱传疾病，由细菌引起，通过受感染蜱虫的叮咬传播给人类。詹姆斯敦峡谷病毒（JCV）是一种新出现的蚊媒病原体，主要在美国中西部上游和东北部地区发现。此前尚未报道过这两种病原体的共同感染，因为这需要宿主同时被两种受感染的病媒叮咬。我们报告了一名36岁男性，他出现了游走性红斑和脑膜炎。虽然游走性红斑是早期局限性莱姆病的特征性体征，但莱姆脑膜炎并非发生在这个阶段，而是在早期播散阶段。此外，脑脊液检查不支持神经莱姆病，该患者最终被诊断为JCV脑膜炎。我们回顾了JCV感染、莱姆病以及这首例报告的共同感染病例，以说明不同病媒和病原体之间的复杂相互作用，并强调在病媒流行地区居住的人群中考虑共同感染的重要性。
