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High-dose intravenous penicillin G does not prevent further progression in early neurological manifestation of Lyme borreliosis

Intravenöse hochdosierte Therapie mit Penicillin G verhindert nicht das Fortschreiten früher neurologischer Manifestationen der Lyme Borreliose

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Summary

We report two cases of Lyme borreliosis (LB) with erythema migrans (EM) and simultaneous meningopolyneuritis with radicular pain and lymphocytic pleocytosis in the cerebrospinal fluid (CSF). EM and pain disappeared completely under high-dose penicillin G therapy within few a days. Pathological findings in CSF improved. Nevertheless, during and after therapy, neurological signs of LB developed: cranial nerve palsies as well as paresis of extremity muscles with radicular distribution.

Zusammenfassung

Wir berichten über zwei Patienten im Frühstadium einer Lyme Borreliose. Neben einem Erythema migrans deuteten radikuläre Schmerzen und ein pathologischer Liquorbefund auf eine gleichzeitige lymphozytäre Meningopolyneuritis Bannwarth hin. Eine frühzeitige hochdosierte Penicillin G-Therapie führte rasch zu einer vollständigen Rückbildung des Erythems und der Schmerzen. Im weiteren Verlauf entwickelten sich jedoch, während und nach der antibiotischen Therapie, neurologische Ausfälle mit Hirnnerven-Lähmungen und peripheren Extremitätenparesen.

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Authors and Affiliations

  1. Neurologische Universitätsklinik und Poliklinik, Hansastr. 9, D-7800, Freiburg

    J. Kohler M.D.

  2. Universitätskinderklinik, D-7800, Freiburg

    H. Schneider M.D.

  3. Institut für medizinische Mikrobiologie und Hygiene, Abt. Immunologie, Universitätsklinik, 7800, Freiburg

    A. Vogt M.D.

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  1. J. Kohler M.D.
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  2. H. Schneider M.D.
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  3. A. Vogt M.D.
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Kohler, J., Schneider, H. & Vogt, A. High-dose intravenous penicillin G does not prevent further progression in early neurological manifestation of Lyme borreliosis. Infection 17, 216–217 (1989). https://doi.org/10.1007/BF01639522

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  • DOI: https://doi.org/10.1007/BF01639522

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