[Severe meningoencephalitis in Borrelia burgdorferi infection]

We present a case of borreliosis with severe impairment of central nervous system. The patient a 43-year-old man, presented with neurological signs and symptoms and severe psychiatric disorders. The diagnosis was established several months after the onset of neurological signs. CSF examination revealed lymphocyte pleocytosis and specific antibodies against B. burgdorferi in high titres. MRI of the brain showed inflammatory lesions. Due to the treatment with antibiotics, patient's state improved and pleocytosis in CSF disappeared. However, after 1- year follow-up, specific antibodies were still present in high titres. Clinical manifestations and the results of diagnostic procedures show multifocal encephalitis in the acute phase of the disease and encephalopathy as a residual syndrome.