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Invasion of the Central Nervous System by Borrelia burgdorferi in Acute Disseminated Infection
Benjamin J. Luft, MD; Charles R. Steinman, MD; Harold C. Neimark, PhD; Bethi Muralidhar, PhD; Thomas Rush, MD; Michael F. Finkel, MD; Mark Kunkel, MD; Raymond J. Dattwyler, MD JAMA. 1992;267(10):1364-1367. doi:10.1001/jama.1992.03480100070033. Text Size: A A A
excerpt:
Results. —Eight of the 12 patients (four of six with multiple areas of erythema migrans and four of six with cranial neuritis without erythema migrans) had B burgdorferi—specific DNA in their CSF. Among the 12 patients studied, nine had acute cranial neuritis and six had multiple erythema migrans lesions.
Just four of the eight who were found to have spirochetal DNA in their CSF had complaints suggestive of CNS infection. In three of the PCR-positive CSF samples, no other abnormalities were noted. None of 16 samples from controls were positive in the PCR assay.
Conclusion. —B burgdorferi can invade the CNS early in the course of infection. Careful consideration should be given to choosing antibiotics that achieve adequate CSF levels in patients with disseminated infection.(JAMA. 1992;267:1364-1367)
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