A case of ocular lesions in a patient with both tick borne borreliosis and toxoplasmosis
V. M. Sakovych 1, S. B. Ustymenko 2, L. G. Berezniuk 2, N. A. Garkava 1
1 Dnipro State Medical University; Dnipro (Ukraine)
2 Dnipro Regional Eye Hospital; Dnipro (Ukraine)
Background: The prevalence of tick borne borreliosis has increased significantly in recent years. There have been reports on conjunctivitis, anterior uveitis, optic neuritis and other inflammatory eye diseases caused by Borrelia species.
Case: This case of successful treatment of focal chorioretinitis caused by Borrelia burgdorferi/Toxoplasma gondii co-infection indicates that elucidating etiology and administering etiological therapy are essential for successful treatment outcomes.
Discussion: Since there are few reports in the literature describing the ocular manifestations of Lyme disease, borreliosis is infrequently suspected by ophthalmologists as an etiologic factor in the development of inflammatory eye disease. Consequently, an enzyme immunoassay for Borrelia burgdorferi is not used in a routine diagnostic evaluation of patients with inflammatory eye disease.
Conclusion: Specific Borrelia burgdorferi antibody serology is required to elucidate the etiology of ocular inflammation if a patient has a history of tick bites even in the absence of symptoms of Lyme disease. In addition, one should take in account that ocular infections are frequently mixed in nature.
Keywords: tick borne borreliosis, Lyme disease, chorioretinitis
1.Yankovskaya YD, Chernobrovkina TY, Koshkin MI. [Status update on the problem of ixodic Lyme disease]. Archives of Internal Medicine. 2015; 6 (26): 21-27. Russian.
2.Bondarenko AV, Mogylenets OI, Katsapov DV. [Laboratory diagnosis of Ixodes tick-borne borreliosis]. In: [Proceedings of National Ukrainian Conference on the Current Aspects of Infectious Diseases in the Practice of an Internist]. Sumy, Ukraine, 15-16 June, 2016. p. 23-25. Ukrainian.
3.Loskutov IV. [Ocular manifestations and treatment of Lyme disease]. Rossiiskii meditsinskii zhurnal. 1997;5:8. Russian.
4.Chemych MD, Lutai IV. [Lyme disease: current state of the problem]. Skhidnoukrainskyi medychyi zhurnal. 2020;8(2):230-41. Ukrainian.
5.Shkilna MI, Andreichyn ML, Korda MM, Klishch IM, Zaporozhan SJ, Guk MT. [Lyme disease and other transmissible infections: diagnosis, treatment and prevention]. Aktualna Infektologiia. 2018; 5: 309-10. Ukrainian.
6.Sarkisan DS. [Ixodes tick-borne borreliosis: current state of the problem]. Infektsionnyie bolezni. 2015; 13(2):61-7. Russian.
7.Sarksian DS, Maleev VV, Platonov EV. [Differential diagnosis of Ixodes tick-borne borreliosis caused by Borrelia miyamotoi]. Infektsionnyie bolezni. 2012; 10(4): 41-44. Russian.
8.Stanek G, Wormser GP, Gray J, Strle F. Lyme borreliosis. Lyme borreliosis. Lancet. 2012 Feb 4;379(9814):461-73.
9.Brouqui P. Guidelines for the diagnosis of tick borne bacterial diseases in Europe. Clin Microbiol Infect. 2004 Dec;10(12):1108-32.
10.Krupinina VS, Utenkova E.O. [Ocular manifestations of tick-borne borreliosis]. Tochka zreniia. Vostok-Zapad. 2014; 2:60. Russian.
11.Shapiro ED. Lyme Disease. N Engl J Med. 2014;1:21-6.
Conflict of Interest: The authors declare no conflict of interest which could influence their opinions on the subject or the materials presented in the manuscript.