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Temporal arteritis associated with Borrelia infection. A case report.
L D Pizzarello1, A B MacDonald, R Semlear
1Southampton Hospital, New York 11968.
Journal of Clinical Neuro-Ophthalmology
|March 1, 1989
Summary
A rare case of sudden vision loss in an elderly man was linked to Borrelia spirochetes, not just giant cell arteritis. Early detection and antibiotic treatment showed potential for partial sight recovery.
Area of Science:
- Infectious Diseases
- Ophthalmology
- Rheumatology
Background:
- Giant cell arteritis (GCA) is a common cause of sudden vision loss in older adults, typically treated with corticosteroids.
- Diagnosis of GCA is often confirmed by temporal artery biopsy.
- Steroid resistance necessitates exploring alternative etiologies for vision loss.
Observation:
- A 71-year-old male presented with acute vision loss and headache, initially suspected as GCA.
- Temporal artery biopsy showed features consistent with GCA, but steroid therapy was ineffective.
- Subsequent blood cultures and biopsy staining revealed Borrelia species spirochetes.
Findings:
- This case is the first to report the presence of Borrelia spirochetes in a temporal artery biopsy.
- The patient experienced limited visual recovery following intravenous ceftriaxone treatment.
- This suggests a potential role for Borrelia infection in arteritis-related vision loss.
Implications:
- Challenges the conventional understanding of GCA etiology and treatment.
- Highlights the importance of considering infectious causes, like Borrelia, in refractory cases of suspected GCA.
- Suggests a potential new therapeutic approach for specific causes of arteritis-induced vision loss.