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Updated: Oct 31, 2025

Visualizing Impairment of the Endothelial and Glial Barriers of the Neurovascular Unit during Experimental Autoimmune Encephalomyelitis In Vivo
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Papilledema as the Sole Manifestation of Neuroborreliosis

Kaitlyn May1, Shankar Upadhyayula2

  • 1Department of Pediatrics, Akron Childrens Hospital, Akron, OH, USA.

Case Reports in Infectious Diseases
|July 1, 2021
PubMed

Insights

Lyme disease, a growing concern, can present with unusual symptoms like papilledema, even in children. Clinicians should consider Lyme disease in patients with isolated eye problems, especially in endemic areas.

Area of Science:

  • Infectious Diseases
  • Ophthalmology
  • Pediatrics

Background:

  • Lyme disease is a significant public health issue with a high number of diagnosed cases annually.
  • Geographic areas affected by Lyme disease are expanding, increasing the potential patient population.
  • Uncommon presentations of Lyme disease require increased clinical awareness.

Observation:

  • A 5-year-old girl presented with papilledema as the sole symptom of Lyme disease.
  • Her ocular symptoms, specifically papilledema, were intermittent and exacerbated by fatigue.
  • The patient's presentation occurred outside the typical Lyme disease season.

Findings:

  • Papilledema can be an isolated manifestation of Lyme disease.
  • Intermittent and fatigue-related ocular symptoms may indicate Lyme disease.
  • Lyme disease should be considered in the differential diagnosis of ophthalmic findings in endemic regions.

Implications:

  • Clinicians must consider Lyme disease in patients with isolated ophthalmic findings, even if atypical.
  • Early recognition of uncommon Lyme disease presentations is crucial for timely diagnosis and treatment.
  • Awareness of Lyme disease's expanding range and varied manifestations is vital for healthcare providers.

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