tailieunhanh - báo cáo khoa học: " Lyme neuroborreliosis in HIV-1 positive men successfully treated with oral doxycycline: a case series and literature review"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Lyme neuroborreliosis in HIV-1 positive men successfully treated with oral doxycycline: a case series and literature review | Bremell et al. Journal of Medical Case Reports 2011 5 465 http content 5 1 465 JOURNALOF medical Ur Case REPORTS CASE REPORT Open Access Lyme neuroborreliosis in HIV-1 positive men successfully treated with oral doxycycline a case series and literature review Daniel Bremell1 Christer Sall2 Magnus Gisslén1 and Lars Hagberg1 Abstract Introduction Lyme neuroborreliosis is the most common bacterial central nervous system infection in the temperate parts of the northern hemisphere. Even though human immunodeficiency virus HIV -1 infection is common in Lyme borreliosis endemic areas only five cases of co-infection have previously been published. Four of these cases presented with typical Lyme neuroborreliosis symptoms such as meningoradiculitis and facial palsy while a fifth case had more severe symptoms of encephalomyelitis. All five were treated with intravenous cephalosporins and clinical outcome was good for all but the fifth case Case presentations We present four patients with concomitant presence of HIV-1 infection and Lyme neuroborreliosis diagnosed in Western Sweden. Patient 1 was a 60-year-old Caucasian man with radicular pain and cognitive impairment. Patient 2 was a 39-year-old Caucasian man with headaches leg weakness and pontine infarction. Patient 3 was a 62-year-old Caucasian man with headaches tremor vertigo and normal-pressure hydrocephalus. Patient 4 was a 50-year-old Caucasian man with radicular pain and peripheral facial palsy. Patients one two and three all had subnormal levels of CD4 cells indicating impaired immunity. All patients were treated with oral doxycycline with good clinical outcome and normalization of CSF pleocytosis. Conclusion Given the low HIV-1 prevalence and medium incidence of Lyme neuroborreliosis in Western Sweden where these four cases were diagnosed co-infection with HIV-1 and Borrelia is probably more common than previously thought. The three patients that were the most immunocompromised suffered .