Volume 24, Issue 105, September - October, 2020

Pediatric neuroinfection caused by Borrelia burgdorferi and Varicella-zoster virus: A case report

Olha Shvaratska^1♦, Victor Mavrutenkov², Tatiana Mavrutenkova³

¹MD, PhD, Associate Professor, Department of Pediatrics 3 and Neonatology, State Establishment "Dnipropetrovsk Medical Academy of Health Ministry of Ukraine", Dnipro, Ukraine;
²DM, Professor, Department of Infectious Diseases, State Establishment “Dnipropetrovsk Medical Academy of Health Ministry of Ukraine”, Dnipro, Ukraine;
³PhD, Department of PCR Diagnostics, Diagnostic Center of Medical Academy, Dnipro, Ukraine

^♦Corresponding author
Associate Professor, Department of Pediatrics 3 and Neonatology, State Establishment "Dnipropetrovsk Medical Academy of Health Ministry of Ukraine", Dnipro, Ukraine; Email: olbelava@gmail.com

ABSTRACT

Background: Pediatric co-infections are an emerging problem due to their ascending prevalence and tendency to blur typical clinical presentation of particular diseases. Case presentation: The paper describes a verified case of Varicella-zoster virus and Borrelia burgdorferi co-infection in a 7-year-old male patient. Neuroinfection manifested ten days after the onset of varicella episode. Acyclovir IV was initiated for acute varicella zoster encephalitis. Concerned with the progression of neurological disorders we performed additional cerebrospinal fluid PCR testing for other potential neuropathogens; Borrelia burgdorferi DNA was detected. The patient denied any history of tick exposure. Combination of ceftriaxone and acyclovir IV was effective. Discussion: Co-infection with Varicella-zoster virus and B. burgdorferi may have a permissive deleterious impact on the central nervous system with unclear mechanisms. Testing for molecular biological and/or serological markers of Lyme disease should be a standard procedure in patients with any severe neuroinfection in endemic regions regardless of anamnestic data.

Keywords: Varicella-zoster infection; Borrelia burgdorferi; Lyme disease; encephalitis; children

Medical Science, 2020, 24(105), 3413-3420

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