Case report: papillitis as the sole ocular sign in Lyme disease

Katherine McVeigh, Georgios VakrosDepartment of Ophthalmology, Raigmore Hospital, Inverness, United KingdomBackground: Lyme disease is a spirochetal disease responsible for a multitude of ocular and systemic manifestations, and patients may present to ophthalmologists and general clinicians with a w...

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Autores principales:	McVeigh K, Vakros G
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/b11da462e6564cf9b3ccce9c191762d5
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spelling	oai:doaj.org-article:b11da462e6564cf9b3ccce9c191762d52021-12-02T00:18:15ZCase report: papillitis as the sole ocular sign in Lyme disease1177-54671177-5483https://doaj.org/article/b11da462e6564cf9b3ccce9c191762d52012-07-01T00:00:00Zhttp://www.dovepress.com/case-report-papillitis-as-the-sole-ocular-sign-in-lyme-disease-a10406https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Katherine McVeigh, Georgios VakrosDepartment of Ophthalmology, Raigmore Hospital, Inverness, United KingdomBackground: Lyme disease is a spirochetal disease responsible for a multitude of ocular and systemic manifestations, and patients may present to ophthalmologists and general clinicians with a wide variety of generalized and ocular signs which can result in chronic and disabling sequelae. Here we report two cases of patients suffering with Lyme disease who developed a rare associated papillitis.Methods: A 48-year-old Scottish man presented with diminished visual acuity, painful ocular eye movements, photophobia, and mild ataxia. Fundus examination revealed bilateral disc swelling with associated hemorrhages in the right eye. Following exclusion of raised intracranial pressure as the cause of the findings, enzyme-linked immunosorbent assay and Western blot serology confirmed a positive result for Borrelia burgdorferi which, along with ophthalmic signs and exposure to an endemic area, confirmed the diagnosis of Lyme disease. A 79-year-old gentleman presented with intermittent short-duration &ldquo;gray film&rdquo; in his left eye. Fundus examination revealed left optic disc swelling. He was positive for Lyme&rsquo;s serology and his condition was treated with 2 weeks of intravenous ceftriaxone.Results: The first patient&rsquo;s inflammation resolved and visual acuity returned to normal following a course of high-dose steroids and intravenous ceftriaxone, followed by oral doxycycline. The second patient&rsquo;s condition improved with high-dose intravenous ceftriaxone.Conclusion: These patients highlight the fact that Lyme disease should be considered as a differential diagnosis for patients presenting with papillitis. With the incidence of this disease rising and more cases being reported, practitioners in Lyme-endemic areas need to be aware of the various manifestations so that appropriate referrals for treatment can be made.Keywords: Lyme disease, ocular papillitis, Borrelia burgdorferiMcVeigh KVakros GDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2012, Iss default, Pp 1093-1097 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 McVeigh K Vakros G Case report: papillitis as the sole ocular sign in Lyme disease
description	Katherine McVeigh, Georgios VakrosDepartment of Ophthalmology, Raigmore Hospital, Inverness, United KingdomBackground: Lyme disease is a spirochetal disease responsible for a multitude of ocular and systemic manifestations, and patients may present to ophthalmologists and general clinicians with a wide variety of generalized and ocular signs which can result in chronic and disabling sequelae. Here we report two cases of patients suffering with Lyme disease who developed a rare associated papillitis.Methods: A 48-year-old Scottish man presented with diminished visual acuity, painful ocular eye movements, photophobia, and mild ataxia. Fundus examination revealed bilateral disc swelling with associated hemorrhages in the right eye. Following exclusion of raised intracranial pressure as the cause of the findings, enzyme-linked immunosorbent assay and Western blot serology confirmed a positive result for Borrelia burgdorferi which, along with ophthalmic signs and exposure to an endemic area, confirmed the diagnosis of Lyme disease. A 79-year-old gentleman presented with intermittent short-duration &ldquo;gray film&rdquo; in his left eye. Fundus examination revealed left optic disc swelling. He was positive for Lyme&rsquo;s serology and his condition was treated with 2 weeks of intravenous ceftriaxone.Results: The first patient&rsquo;s inflammation resolved and visual acuity returned to normal following a course of high-dose steroids and intravenous ceftriaxone, followed by oral doxycycline. The second patient&rsquo;s condition improved with high-dose intravenous ceftriaxone.Conclusion: These patients highlight the fact that Lyme disease should be considered as a differential diagnosis for patients presenting with papillitis. With the incidence of this disease rising and more cases being reported, practitioners in Lyme-endemic areas need to be aware of the various manifestations so that appropriate referrals for treatment can be made.Keywords: Lyme disease, ocular papillitis, Borrelia burgdorferi
format	article
author	McVeigh K Vakros G
author_facet	McVeigh K Vakros G
author_sort	McVeigh K
title	Case report: papillitis as the sole ocular sign in Lyme disease
title_short	Case report: papillitis as the sole ocular sign in Lyme disease
title_full	Case report: papillitis as the sole ocular sign in Lyme disease
title_fullStr	Case report: papillitis as the sole ocular sign in Lyme disease
title_full_unstemmed	Case report: papillitis as the sole ocular sign in Lyme disease
title_sort	case report: papillitis as the sole ocular sign in lyme disease
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/b11da462e6564cf9b3ccce9c191762d5
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Case report: papillitis as the sole ocular sign in Lyme disease

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