RT Journal Article
SR Electronic
T1 Borrelia Hispanica: an Emerging Infectious Agent Causing Neuroborreliosis (P6.310)
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP P6.310
VO 84
IS 14 Supplement
A1 Cerdan, Maria
A1 Sánchez Martínez, Iria
A1 Palazon Cabanes, Begoña
A1 Carreon Guarnizo, Ester
A1 Anda Fernandez, Pedro
A1 Escudero Nieto, Raquel
A1 Meca La Llana, Jose
YR 2015
UL http://n.neurology.org/content/84/14_Supplement/P6.310.abstract
AB OBJECTIVE: We present a case of neuroborreliosis due to Borrelia Hispanica (BH) infection with central nervous system (CNS) involvement, analyzing the diagnostic, epidemiologic, and therapeutic management aspects. BACKGROUND: Involvement of the nervous system by Borrelia burgdorferi in Lyme disease reaches 15[percnt], but is very rare in infection by BH. DESIGN/METHODS: Spanish, 35 year old male, hunter, with recurrent fever for 6 months in the previous year, without final diagnosis, and consulting due to subacute grade 3/5 left facio-brachial hemiparesis. Brain magnetic resonance imaging (MRI) showed extensive right frontal infiltrative subcortical lesion, hyperintense on T2 sequence and with nodular enhancement after contrast. Spectroscopy: Cho peak with decreased NAA. RESULTS: The radiological and autoimmunity studies were negative for systemic disease. Systemic and cerebrospinal fluid serologies were positive for IgG anti-Borrelia burgdorferi. The cerebrospinal fluid analysis showed PCR positive for Borrelia hispanica. The administration of megadoses of steroids during 5 days and ceftriaxone 2 g/24h intravenously for 15 days lead to a significant clinical and radiological improvement. CONCLUSIONS: BH infection uses as a vector the tick Ornithodoros erraticus and its clinical expression is relapsing fever. BH is located mainly in Morocco and recently its genome has been sequenced. After an extensive review of the literature (Pubmed) we did not find any cases of CNS involvement by BH. The case presented above was characterized by the virulent CNS involvement by BH, the neuroimaging findings and therapeutic management, which may help to identify similar cases. If new cases confirmed the settlement of this zoonosis in Spain, an epidemiological study and control in mammals would be required.Disclosure: Dr. cerdan has nothing to disclose. Dr. Sánchez Martínez has nothing to disclose. Dr. Palazon Cabanes has nothing to disclose. Dr. Carreon Guarnizo has nothing to disclose. Dr. Anda Fernandez has nothing to disclose. Dr. Escudero Nieto has nothing to disclose. Dr. Jose has nothing to disclose.Thursday, April 23 2015, 7:30 am-12:00 pm