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Correspondence
Immunosuppressive treatment for vasculitis associated with Lyme borreliosis
  1. R KOMDEUR,
  2. J G ZIJLSTRA,
  3. T S VAN DER WERF,
  4. J J M LIGTENBERG,
  5. J E TULLEKEN
  1. Department of Internal Medicine
  2. Intensive and Respiratory Care Unit (ICB)
  3. University Hospital Groningen
  4. The Netherlands
  1. Dr J E Tulleken, Intensive and Respiratory Care Unit (ICB), Department of Internal Medicine, University Hospital Groningen, PO 30.001, 9700 RB Groningen, The Netherlands j.e.tulleken{at}int.azg.nl

https://doi.org/10.1136/ard.60.7.721

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    Vasculitis of the central nervous system is a rare complication of Lyme borreliosis.1 ,2 We now report a case of early onset borrelia associated encephalitis followed by systemic vasculitis. Antibiotics failed to improve the clinical course and remission was only reached after extensive immunosuppressive treatment.

    A 52 year old man was admitted because of fever, headache, tinnitus, and painful joints. He reported a tick bite on his left arm, which had occurred three weeks earlier and which was followed by a reddish skin eruption. His general practitioner started treatment with doxycycline, but the patient's condition worsened. The patient had a fever of 39.9°C; further physical examination showed no other abnormalities. Except for an erythrocyte sedimentation rate of 51 mm/1st h and a leucocyte count of 16.1×109/l, routine …

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