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Neuroborreliosis with progression from pseudotumor cerebri to aseptic meningitis

Andrew P Steenhoff1, Michael J Smith, Samir S Shah

  • 1Division of Infectious Diseases, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA, USA. Steenhoff@email.chop.edu

The Pediatric Infectious Disease Journal
|January 6, 2006
PubMed

Insights

Lyme disease can mimic other conditions. This case highlights how Lyme meningitis may present initially as pseudotumor cerebri, emphasizing the need for neuroborreliosis consideration in diagnosis.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Ophthalmology

Background:

  • Pseudotumor cerebri (PTC) is a condition characterized by increased intracranial pressure without a clear cause.
  • Lyme disease, caused by Borrelia burgdorferi, can manifest with diverse neurological symptoms.

Observation:

  • A patient initially diagnosed with Lyme-associated pseudotumor cerebri later developed cerebrospinal fluid (CSF) findings indicative of Lyme meningitis.
  • The clinical presentation evolved, revealing a deeper infectious process.

Findings:

  • Cerebrospinal fluid analysis showed pleocytosis, a key indicator of inflammation in the central nervous system.
  • The CSF findings shifted from those initially suggestive of PTC to those characteristic of Lyme meningitis.

Implications:

  • This case underscores the importance of including neuroborreliosis in the differential diagnosis for patients presenting with pseudotumor cerebri.
  • Recognizing the potential evolution of CSF findings in Lyme disease is crucial for accurate diagnosis and timely treatment.

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