Document Detail

Frequency and clinical significance of Lyme seropositivity in patients with isolated optic neuritis.
MedLine Citation:
PMID:  2027487     Owner:  NLM     Status:  MEDLINE    
We evaluated antibody reactivity against Borrelia burgdorferi in 20 consecutive patients with newly diagnosed isolated optic neuritis who resided in a region endemic for Lyme disease. Four (20%) patients had positive serology. All three patients who had follow-up serologies showed rising convalescent levels of Borrelia-specific IgM. One patient refused lumbar puncture, one had normal CSF constituents except for an elevated Lyme antibody index, and two had CSF lymphocytic pleocytosis that remained unexplained after extensive evaluations for causes other than Lyme disease. We treated both patients who had CSF pleocytosis with intravenous ceftriaxone; the pleocytosis and optic nerve function improved. The other two patients received oral antibiotics and showed excellent recovery of visual acuity. We believe that serologic testing for Lyme disease is warranted for individuals with optic neuritis who reside in an endemic region, and patients with rising convalescent antibody levels or unexplained CSF pleocytosis should receive antibiotic treatment for Lyme disease.
D M Jacobson; J J Marx; A Dlesk
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Neurology     Volume:  41     ISSN:  0028-3878     ISO Abbreviation:  Neurology     Publication Date:  1991 May 
Date Detail:
Created Date:  1991-06-07     Completed Date:  1991-06-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  706-11     Citation Subset:  AIM; IM    
Department of Neurology and Ophthalmology, Marshfield Clinic, WI 54449.
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MeSH Terms
Antibodies, Viral / analysis*
Immunoglobulin G / analysis
Lyme Disease / diagnosis*,  immunology,  radiography
Optic Nerve / radiography
Optic Neuritis / immunology,  microbiology*,  radiography
Tomography, X-Ray Computed
Reg. No./Substance:
0/Antibodies, Viral; 0/Immunoglobulin G

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