[Endogenous paranoid-hallucinatory syndrome caused by Borrelia encephalitis]

Area of Science:

• Neuropsychiatry
• Infectious Diseases
• Medical Case Study

Background:

• Borrelia burgdorferi, the causative agent of Lyme disease, is primarily known for its neurological and rheumatological manifestations.
• Psychiatric symptoms are less commonly recognized but can occur in neuroborreliosis.

Observation:

• A case is presented of a patient with severe psychiatric symptoms, including paranoia and hallucinations, mimicking endogenous schizophrenia.
• The patient exhibited no overt neurological signs initially.
• These symptoms were induced by Borrelia burgdorferi infection.

Findings:

• Psychiatric symptoms resolved within one week of antibiotic treatment with ceftriaxone.
• Following initial improvement, the patient developed a mild organic brain syndrome.
• The case highlights that paranoid symptoms and hallucinations are not specific to psychiatric disorders and can arise from infections.

Implications:

• This case underscores the importance of considering infectious etiologies, such as Borrelia burgdorferi, in patients presenting with new-onset psychosis, especially those without a prior psychiatric history.
• Additional diagnostic measures are essential in such cases to rule out underlying organic causes.
• The findings emphasize the need for a broad differential diagnosis in neuropsychiatric presentations.