Dados do Trabalho

Título

Neuroborreliosis, a rare condition in Brazil - A Case Report

RESUMO

Clinical case: A 37-year-old, male pacient presented weakness in the lower limbs that was initially attributed to ciatalgia associated with muscle shortening since 2019. Due to the worsening of the condition with low back pain and cramps, he sought out other professionals who diagnosed him with axial spondyloarthritis and started treatments with non-steroidal anti-inflammatories and sulfasalazine. More than 2 years after the onset of symptoms, consultations with some specialists and progressive worsening of the condition, with associated headache and memory loss, the patient underwent an electroneuromyography that showed axonal neuropathy of the posterior tibial nerves and denervation in activity, and a test of ELISA confirmed with Western Blotting for positive Borrelia burgdorferi in different laboratories of excellence. Treatment was started with 28 days of ceftriaxone and continued for two more months with doxycycline. Discussion: As evidenced in the case, the clinical manifestations of Brazilian neuroborreliosis - Baggio-Yoshinari Syndrome - can mimic multiple diseases and are poorly described so far. Consequently, neuroborreliosis can be overlooked by the clinician, especially in non-endemic areas, and has characteristics of recurrence and a tendency to cause chronic neurological and joint manifestations, especially if antibiotic treatment is instituted late. Final Comments: This is a challenging diagnostic zoonosis, with clinical symptoms suggestive of other pathologies and serological tests of limited sensitivity and specificities. Therefore, further studies on the neurological involvement of this syndrome are essential to bring attention to this differential diagnosis for an effective and early treatment.