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- W4384010020 abstract "Introduction: First described in Brazil in 1992, Lyme disease (LD) is a multisystem bacterial infection caused by Borrelia burgdorferi and transmited by infected ticks of the genus Ixodes or Amblyomma. LD prevails in temperate climate countries, with some few cases reported in Brazil. In early disseminated LD, main neurologic findings are meningitis, cranial neuropathy, radiculoneuropathy, cerebellar ataxia and encephalomyelitis. Neurologic features of late LD include confluent mononeuropathy multiplex, peripheral neuropathy and encephalopathy. Diagnosis is essencially clinical, with possibility of serologic testing. The treatment includes antibiotics and must be individualized. Objectives: We aim to present a LD case with stroke-like presentation. Results: A 43-year-old man presented with central facial palsy, vertical nystagmus, headache, vertigo and nausea. Magnetic resonance imaging (MRI) showed hyperintense oval lesion in T2/FLAIR in the left middle cerebellar peduncle, with diffusion restriction. At first, he was diagnosed with of ischaemic stroke. After two weeks of symptoms onset, MRI showed an enhancement in the previous cerebellar lesion with normal angiogram. Cerebrospinal fluid analysis was also normal. The patient received a 5-day pulse therapy, with partial clinical response and yet, a new MRI showed an increased lesion with the same previous features and CSF protein of 71. Viral CSF screening, cryptococcal and cysticercosis antigens, oligoclonal bands were negative. LD serology came out positive, allowing the treatment with ceftriaxone for 28 days. Due to partial response, alternative treatment with benzathine penicillin, doxycycline and tinidazole was instituted, achieving satisfactory results. Conclusion: LD may mimic other neurologic syndromes, thus neurologists frequently ought to consider it as a differential diagnosis." @default.
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- W4384010020 date "2023-01-01" @default.
- W4384010020 modified "2023-09-30" @default.
- W4384010020 title "Stroke-like symptoms in Lyme Disease, a case report" @default.
- W4384010020 doi "https://doi.org/10.5327/1516-3180.141s1.747" @default.
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