Optic disc edema and Lyme disease.

A seven-year-old child developed a febrile rash, migratory arthritis, and neurologic signs. Three days earlier, the child had been bitten by a tick. An eye examination two months later revealed bilateral papilledema, although the cerebrospinal fluid pressure was 170 mm. The IgM antibody titer for the Ixodes dammini spirochete was 1:256. I dammini is the tick vector for the Borrelia spirochete that causes Lyme disease. The papilledema receded with treatment over a month's time, and bilateral pigment epithelial mottling at the fovea was present after one year.