J Am Vet Med Assoc. 2010 Nov 15;237(10):1180-5.
Meningitis, cranial neuritis, and radiculoneuritis associated with Borrelia
burgdorferi infection in a horse.
James FM, Engiles JB, Beech J.
Departments of Clinical Studies, New Bolton Center, School of Veterinary
Medicine, University of Pennsylvania, Kennett Square, PA 19348.
Case Description-A 12-year-old Thoroughbred was examined because of signs of
depression, neck stiffness, and poor performance.
Clinical Findings-Physical examination revealed that the horse was dull, appeared depressed, was reluctant to raise its neck and head above a horizontal plane, and had a temperature of 38.5 degrees C (101.3 degrees F). No radiographic or scintigraphic abnormalities of the neck were found; however, high plasma fibrinogen concentration and
relative lymphopenia were identified and the horse was seropositive for
antibodies against Borrelia burgdorferi. Analysis of CSF revealed neutrophilic
inflammation, and results of a PCR assay of CSF for B burgdorferi DNA were
positive. Immunologic testing revealed severe B-cell lymphopenia and a low serum
IgM concentration consistent with common variable immunodeficiency.
Treatment and Outcome-The horse responded well to doxycycline treatment (10 mg/kg [4.5
mg/lb], PO, q 12 h for 60 days) and returned to normal exercise. However, 60
days after treatment was discontinued, the horse again developed a stiff neck
and rapidly progressive neurologic deficits, including severe ataxia and
vestibular deficits. The horse's condition deteriorated rapidly despite IV
oxytetracycline treatment, and the horse was euthanatized. Postmortem
examination revealed leptomeningitis, lymphohistiocytic leptomeningeal
vasculitis, cranial neuritis, and peripheral radiculoneuritis with Wallerian
degeneration; findings were consistent with a diagnosis of neuroborreliosis.
Clinical Relevance-Nervous system infection with B burgdorferi should be
considered in horses with evidence of meningitis and high or equivocal serum
anti-B burgdorferi antibody titers. Evaluation of immune function is recommended
in adult horses evaluated because of primary bacterial meningitis.
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PMID: 21073390 [PubMed - in process]