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Lyme Disease

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Emerging Infectious Uveitis

Abstract

Lyme borreliosis is the most frequent tick-derived disease in the northern part of the world (USA, Europe, Japan). The term Lyme disease (LD) is defined as an infectious condition which spreads all over the human body; the first manifestation begins as a skin lesion (erythema migrans) resulting from the infected tick bite which is followed, later on, by central nervous system (CNS) involvement so-called neuroborreliosis (with signs and symptoms of aseptic meningitis and cranial and peripheral neuropathies) and by cardiac involvement (Lyme carditis with atrioventricular blocks), followed by joint inflammation (arthritis with intermittent acute inflammatory attacks of one or more joints), and later on by partial or full involvement of the eye. The disease occurs in three stages (as in syphilis), but LD complete presentation is very unusual. Borrelia invades the eye at an early stage, but ocular manifestations are a rare feature of the disease and frequently remain underdiagnosed; they can occur at different stages of the disease, occasionally developing at early stages, or at any time between a few weeks and years after the infected tick bite.

Ocular manifestations can involve any of the ocular structures, the more frequent signs however being nummular, interstitial, or ulcerative keratitis (a frequent early finding) and uveitis and retinal vasculitis or neuroretinitis with unilateral or bilateral optic disc involvement (as late signs).

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Authors and Affiliations

  1. Ophthalmology Department, Uveitis Tertiary Referral Center, Rapallo Hospital, Via San Pietro, 8–Rapallo, Genova, Italy

    Pia Allegri

  2. Montchoisi Ophthalmology Teaching Unit, Centre for Ophthalmic Specialised Care (COS), Rue Charles-Monnard, Lausanne, Switzerland

    Carl P. Herbort Jr.

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  1. Pia Allegri
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  2. Carl P. Herbort Jr.
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Correspondence to Pia Allegri .

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  1. Singapore National Eye Center, Singapore, Singapore

    Soon-Phaik Chee

  2. Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, Monastir, Tunisia

    Moncef Khairallah

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Allegri, P., Herbort, C.P. (2017). Lyme Disease. In: Chee, SP., Khairallah, M. (eds) Emerging Infectious Uveitis. Springer, Cham. https://doi.org/10.1007/978-3-319-23416-8_5

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