Debate over chronic Lyme

Full article: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=20972087&retmode=ref&cmd=prlinks

Excerpt:

A 58-year-old lady who had waxing and waning nonspecific symptoms
including fatigue and unsteadiness for 15 months became
acutely confused 12 h prior to presentation. Her travel
history prior to presentation consisted of visits to Argentina,
Chile and the Outer Hebrides. On admission to a district hospital
she was pyrexial and unresponsive. CT was normal, she had a
lymphocytic pleocytosis of 500, protein of 1 g, a low
glucose ratio and type 2 oligoclonal bands, CSF cytology and HSV
were negative. Baseline blood tests, tumour markers, autoimmune
screening including paraneoplastic antibodies and voltage-gated
potassium channel antibodies were also negative. Magnetic
resonance imaging revealed multiple abnormal areas of high signal
on T2 FLAIR sequencing within the cerebellum, temporal lobes, and
periventricular areas.
Western blotting of serum and CSF for Borrelia burgdoferi were
both positive.
She was treated with cefuroxime and acyclovir and within
24 h she was alert and responsive. She received 4 weeks of
cefuroxime in total and made a good recovery. Lyme disease should
be considered in patients with acute meningoencephalitis preceded
by nonspecific waxing and waning symptoms even if a tick bite or
erythema is not recalled.