Late Lyme neuroborreliosis with chronic encephalomyelitis

This is the authors' abstract. We don't add key points for this paper.

A 34-year-old man developed, over 7 months, progressive gait disorder and sphincter dysfunction. Examination demonstrated spastic and ataxic paraparesis. MRI revealed extensive meningo-myelitis (figure). Anti- Borrelia burgdorferi (Bb) immunoglobulin G (IgG) was positive (by Vidas ELFA, BioMérieux [[Marcy-l'Étoile, France][1]], n < 0.2) in the serum (index 6.85) and in the CSF (index 2.68), as was immunoglobulin M in the serum (index 0.54). Lumbar puncture demonstrated pleocytosis (195 leukocytes/μL) and intrathecal synthesis of anti-Bb IgG antibody production (intrathecal synthesis ratio = 4 after correcting for CSF/serum albumin ratio, n < 2). After 4 weeks IV ceftriaxone 2 g daily, the status showed significant improvement. Late Lyme neuroborreliosis, defined as continuous disease lasting more than 6 months, represents less than 2% of all Lyme neuroborreliosis. Definite diagnosis can be made in the presence of suggestive neurologic symptoms, CSF pleocytosis, and intrathecal Bb antibody production.1,2 [1]: https://www.google.com/search?q=Marcy-l%27%C3%89toile+France&stick=H4sIAAAAAAAAAOPgE-LUz9U3SLMoK6pQ4gIxjQtzzM2NtbSyk63084vSE_MyqxJLMvPzUDhWGamJKYWliUUlqUXFAIlpjw9FAAAA&sa=X&ved=2ahUKEwj9v4y-987cAhWPVt8KHd19CHMQmxMoATARegQIBhAi