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Hypoglycorrhachia in Lyme meningitis.
Nimrod E Dayan1, Lorry G Rubin, David Di John
1Division of Pediatric Infectious Diseases, Department of Pediatrics, Schneider Children's Hospital of the North Shore-Long Island Jewish Health System, New Hyde Park, NY, USA.
The Pediatric Infectious Disease Journal
|April 9, 2004
Summary
A rare case of acute neuroborreliosis in an 11-year-old girl presented with unusual symptoms. A sixth cranial nerve palsy and severe hypoglycorrhachia were noted, challenging typical neuroborreliosis diagnoses.
Area of Science:
- Neurology
- Infectious Diseases
- Pediatrics
Background:
- Neuroborreliosis, a Lyme disease manifestation, typically affects the nervous system.
- Cranial nerve palsies are common presentations in pediatric neuroborreliosis.
Observation:
- An 11-year-old previously healthy female presented with acute neurological symptoms.
- The patient exhibited left sixth cranial nerve palsy and signs of elevated intracranial pressure.
Findings:
- Cerebrospinal fluid analysis revealed a markedly elevated leukocyte count and protein concentration.
- Severe hypoglycorrhachia was observed, which is atypical for neuroborreliosis.
- The combination of symptoms and laboratory findings presented a diagnostic challenge.
Implications:
- This case highlights the importance of considering atypical presentations of neuroborreliosis in children.
- The unusual laboratory findings necessitate a broader differential diagnosis in suspected cases.
- Further research may be needed to understand the spectrum of neuroborreliosis manifestations.