Transient worsening of optic neuropathy as a sequela of the jarisch-herxheimer reaction in the treatment of lyme disease

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A 58-year-old woman developed neurologic and neuro-ophthalmologic manifestations of Lyme disease, including a radiculomyelitis, cranial neuritis and mild right optic neuropathy. Upon treatment with intravenous ceftriaxone a Jarisch-Herxheimer reaction occurred with encephalopathy, mild fever, worsening radiculomyelitis, and deterioration of her visual acuity. Intravenous methyl-prednisolone was given, and the visual acuity recovered over 72 hours. This case suggests that transient worsening of optic neuropathy can develop as a sequela of the Jarisch-Herxheimer reaction in the treatment of Lyme disease.

Original languageEnglish (US)
Pages (from-to)77-80
Number of pages4
JournalJournal of Neuro-Ophthalmology
Issue number2
StatePublished - Jun 1994


ASJC Scopus subject areas

  • Ophthalmology
  • Clinical Neurology

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