2019 Jun 5:1120672119855210. doi: 10.1177/1120672119855210. [Epub ahead of print]

Atypical papillitis: An isolated manifestation of Lyme disease.


Lyme disease is a rare condition caused by the bacterium Borrelia burgdorferi. Despite typical symptoms including fever, headache, fatigue, and a characteristic skin rash, sometimes we cannot find those due to the lack of physician consultation in those early stages. If this disease is left untreated, infection could spread to the nervous system causing neuroborreliosis, an atypical and complicated manifestation of this disease. We present the case of an atypical papillitis, probably caused by this bacterium. We suspected this because of the results on the indirect test bloods and the improvement of the symptoms after treatment. This entity should be considered as a possible diagnosis of atypical optical neuropathies, particularly if it occurs in an endemic area.



Lyme disease is NOT A RARE CONDITION.

Neuroborreliosis is NOT ATYPICAL. It is the inevitable outcome without treatment.

Note that they state the “atypical” papillitis is probably due to Lyme and they make that decision based upon a blood test as well as improvement after treatment.

This is a great example of how doctors should be treating Lyme/MSIDS clinically. They also shouldn’t be fearful of treating this clinically. Due to abysmal serology testing, doctors should understand that testing positive is not a prerequisite, but if symptoms add up, they should treat clinically and look at results.  As they say, “the proof’s in the pudding.”

Lyme/MSIDS should be considered in any neuropathy. It is a well known symptom. 

According to the National Eye institute, papillitis is a twenty dollar word for optic nerve inflammation.

Lyme loves the eyes and nerves and causes wide spread inflammation.


  • loss of vision
  • pain in the eye
  • interference with accurate color vision (dyschromatopsia)


  • Diseases that result in damage to the lining of nerves (demyelinating diseases) such as multiple sclerosis and encephalomyelitis; viral or bacterial infections such as polio, measles, pneumonia, or meningitis
  • nutritional or metabolic disorders such as diabetes, pernicious anemia, and hyperthyroidism
  • secondary complications of other diseases
  • reactions to toxic substances such as methanol, quinine, salicylates, and arsenic
  • trauma

Being in an endemic area has NOTHING to do with this.

Ticks are everywhere, and happily transmitting diseases as they travel. These types of limiting statements by ignorant researchers have been used against patients for decades. Doctors desperately need to study this and stop believing and repeating ancient mythology.

For more on Lyme & eye issues:  The authors described patients with tick-transmitted diseases presenting with the following ophthalmologic findings:

  • Follicular conjunctivitis
  • Periorbital edema and mild photophobia
  • Bell’s palsy, cranial nerve palsies and Horner syndrome
  • Argyll Robertson pupil
  • Keratitis
  • Optic neuritis, papilledema, papillitis and neuroretinitis
  • Myositis of extraocular muscles and dacryoadenitis
  • Episcleritis, anterior and posterior scleritis
  • Anterior, intermediate, posterior and panuveitis
  • Retinal vasculitis, cotton wool spots and choroiditis
  • Retinitis, macular edema and endophthalmitis

I sent all of this information to the first author. Hopefully, she will read it.


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