Meningitis with cranial polyneuritis and cavernous sinus thrombosis by Borrelia crocidurae. First autochthonous case in Europe.
Borrelia crocidurae is endemic in West Africa, where it represents the leading cause of tick-borne relapsing fever (TBRF). TBRF typically presents with high fever and systemic symptoms, followed by recurrent episodes. Neurological complications may occur during febrile relapses. B. crocidurae is considered the most neurotropic agent of TBRF and is associated to severe neurological manifestations i.e. meningitis and encephalitis.
To date, European cases of B. crocidurae infection have been reported in travelers returning from endemic areas. We report the first autochthonous case in Europe of B. crocidurae infection, presenting as meningitis with cranial polyneuritis and cavernous sinus thrombosis that were not preceded by classical febrile recurrences.
This is important as it shows again that Borrelia burgdorferi is not the only borrelia we need to be concerned about. While endemic in Africa, this case is in a non-traveling European demonstrating the prolific spread of ticks and subsequently the pathogens they carry: https://madisonarealymesupportgroup.com/2019/03/09/danish-study-shows-migrating-birds-are-spreading-ticks-their-pathogens-including-places-without-sustainable-tick-populations/
It also demonstrates once again that current CDC 2-tiered testing will NEVER pick this up.
Cranial polyneuritis = inflammation of many nerves simultaneously.
Cavernous sinus thrombosis = when the immune system creates a blood clot to prevent bacteria or other pathogens from spreading within a cavity at the base of the brain which drains deoxygenated blood from the brain back to the heart. Typically it is caused by an infection. The clot increases pressure inside the brain which can cause damage. Mortality is 30%.
Symptoms of cavernous sinus thrombosis may include:
- Severe headache often accompanied by tearing
- Swelling, redness, or irritation around one or both eyes
- Drooping eyelids
- Inability to move the eye
- High fever
- Pain or numbness around the face or eyes
- Vision loss or double vision
- Altered mental status that can range from confusion to coma
Tests for Cavernous Sinus Thrombosis
Treatment of Cavernous Sinus Thrombosis
Doctors treat cavernous sinus thrombosis with high-dose antibiotics. These are usually given though an IV drip.
Corticosteroid medications may also be used to reduce swelling. Blood thinners are sometimes given.
Surgery may be needed to drain the site of the initial infection.