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      Diplopía como primera manifestación de la enfermedad de Lyme Translated title: Diplopia as the first manifestation of Lyme disease

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          Abstract

          Caso clínico: Se presenta un caso de enfermedad de Lyme con diplopía como la primera manifestación del proceso sin síntomas sistémicos de presentación, en contra de lo publicado en otros casos de esta enfermedad. El serodiagnóstico se confirmó con el test ELISA y con la determinación de los anticuerpos en el líquido cefalorraquídeo (LCR). Los síntomas fueron desapareciendo después de la instauración del tratamiento antibiótico. Discusión: La enfermedad de Lyme es una enfermedad multisistémica causada por Borrelia burgdorferi. Las manifestaciones neuro-oftalmológicas ocurren durante el segundo estadio de la enfermedad y con una expresión clínica tremendamente variable.

          Translated abstract

          Case report: We report a case of Lyme disease with diplopia as the first manifestation, without systemic symptoms in contrast with other cases of this disease. The serodiagnosis was confirmed by ELISA analysis and evaluation of cerebrospinal fluid (CSF) antibodies. Symptoms readily vanished after the introduction of antibiotherapy. Discussion: Lyme disease is an infectious multi-systemic disorder caused by Borrelia burgdorferi. Neuro-ophthalmological manifestations occur during the second stage of the illness in extremely variable clinical forms.

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          The expanding clinical spectrum of ocular lyme borreliosis.

          Helena O Mikkilä, Ilkka J.T. Seppälä, Matti Viljanen … (2000)
          To delineate the clinical manifestations of ocular Lyme borreliosis, while concentrating on new symptoms and findings and the phase of appearance of ophthalmologic disorders. Observational case series. Ten patients with Lyme borreliosis-associated ophthalmologic findings previously reported from the Helsinki University Central Hospital in addition to 10 new cases that have since been diagnosed. INTERVENTION/TESTING: The patients underwent medical and ophthalmologic evaluation. The diagnosis of Lyme borreliosis was based on medical history, clinical ocular and systemic findings, determinations of antibodies to Borrelia burgdorferi by enzyme-linked immunosorbent assay and immunoblot analysis, the detection of DNA of B. burgdorferi by polymerase chain reaction, and exclusion of other infectious and inflammatory causes. Ocular complaints, presenting ophthalmologic findings, and the stage of Lyme borreliosis were recorded. Four patients presented with a neuro-ophthalmologic disorder, five had external ocular inflammation, 10 patients had uveitis, and one had branch retinal vein occlusion. One patient developed episcleritis and one patient developed abducens palsy within 2 months of the infection incident. In the remaining 14 patients in whom the time of infection was traced, the ocular manifestations appeared in the late stage of Lyme borreliosis. Two patients with a neuro-ophthalmologic disorder and one with external ocular inflammation experienced severe photophobia, whereas the main reported symptom of the patients with uveitis was decreased visual acuity. Four patients with external ocular disease and one with a neuro-ophthalmologic disorder experienced severe periodic ocular or facial pain. Retinal vasculitis developed in seven patients with uveitis. Lyme borreliosis can cause a variety of ocular manifestations, which develop mainly in the late stage of the disease. Photophobia and severe periodic ocular pain can be characteristic symptoms of Lyme borreliosis. In the differential diagnosis of retinal vasculitis, Lyme borreliosis should be taken into account, especially in endemic areas.
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            Optic neuropathy in children with Lyme disease.

            H Rothermel, T Hedges, A Steere (2001)
            Involvement of the optic nerve, either because of inflammation or increased intracranial pressure, is a rare manifestation of Lyme disease. Of the 4 children reported here with optic nerve abnormalities, 2 had decreased vision months after disease onset attributable to optic neuritis, and 1 had headache and diplopia early in the infection because of increased intracranial pressure associated with Lyme meningitis. In these 3 children, optic nerve involvement responded well to intravenous ceftriaxone therapy. The fourth child had headache and visual loss attributable to increased intracranial pressure and perhaps also to optic neuritis. Despite treatment with ceftriaxone and steroids, he had persistent increased intracranial pressure leading to permanent bilateral blindness. Clinicians should be aware that neuro-ophthalmologic involvement of Lyme disease may have significant consequences. If increased intracranial pressure persists despite antibiotic therapy, measures must be taken quickly to reduce the pressure.
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              The uvea: uveitis and intraocular neoplasmas

              NA Rao, DJ Forster, DJ Spalton … (1991)
              Article 0 comments Cited 1 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                VM Asensio Sánchez: Role: ND
                A Corral Azor: Role: ND
                A Bartolomé Aragón: Role: ND
                M De Paz García: Role: ND
                Journal
                Journal ID (publisher-id): aseo
                Title: Archivos de la Sociedad Española de Oftalmología
                Abbreviated Title: Arch Soc Esp Oftalmol
                Publisher: Sociedad Española de Oftalmología (, , Spain )
                ISSN (Print): 0365-6691
                Publication date (Print and electronic): January 2003
                Volume: 78
                Issue: 1
                Pages: 51-53
                Affiliations
                [01] Medina del Campo Valladolid orgnameHospital General del INSALUD España
                Article
                Publisher ID: S0365-66912003000100012
                DOI: 10.4321/s0365-66912003000100012
                SO-VID: 70694cee-6179-4445-8181-c94fc301a6f4
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

                History
                Date received : 22 November 2001
                Date accepted : 26 June 2002
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 4, Pages: 3
                Product

                SciELO Spain


                Keywords: Enfermedad de Lyme,diplopía,meningitis,Lyme disease,diplopia
                Data availability:
                Keywords: Enfermedad de Lyme, diplopía, meningitis, Lyme disease, diplopia

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