Premium
Detection of Borrelia burgdorferi DNA and complement membrane attack complex deposits in the sural nerve of a patient with chronic polyneuropathy and tertiary lyme disease
Author(s) -
Maimone Davide,
Villanova Marcello,
Stanta Giorgio,
Bonin Serena,
Malandrini Alessandro,
Guazzi Gian Carlo,
Annunziata Pasquale
Publication year - 1997
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/(sici)1097-4598(199708)20:8<969::aid-mus6>3.0.co;2-4
Subject(s) - borrelia burgdorferi , medicine , lyme disease , polyneuropathy , chronic inflammatory demyelinating polyneuropathy , ceftriaxone , sural nerve , pathology , immunology , myelopathy , neuroborreliosis , spinal cord , antibody , biology , microbiology and biotechnology , psychiatry , antibiotics
We report a patient who developed a chronic sensory motor polyneuropathy and a progressive myelopathy 4 years after a tick bite. An increased serum antibody titer to Borrelia burgdorferi suggested a diagnosis of Lyme neuroborreliosis, although a concomitant cervical spondylosis probably contributed to spinal cord damage. Treatment with ceftriaxone resulted in a marked improvement of neuropathic symptoms, providing indirect evidence of spirochetal infection. Search for B. burgdorferi DNA by polymerase chain reaction amplification on sural nerve confirmed the diagnosis, demonstrating that the spirochete localized in the peripheral nervous system. The presence of complement membrane attack complex deposits and macrophage infiltrates around epineurial vessels and within the endoneurium suggests that the neuropathy in our patient was immune‐mediated. © 1997 John Wiley & Sons, Inc. Muscle Nerve 20: 969–975, 1997