First psychotic episode as first manifestation of lyme disease: Case report

• DOI: 10.1192/j.eurpsy.2021.2148
• Publication Date: 2022-02-22T06:58:45Z
• Authors: R. Almeida Leite; M. Almeida; A. Costa; J. Alcafache; A. Mesquita
• Keywords: Psychiatric history; Neurosyphilis

Introduction Lyme disease (LD) is caused by the spirochete Borrelia burgdorferi (Bb) and has been reported to be associated with various psychiatric presentations. Objectives To report a case LD highlight importance of differential diagnosis in first psychotic episode. Methods Case non-systematic review literature. Results A woman aged 31 was admitted department, after car accident mortal victim, due episode visual hallucinations, disorientation time space, persecutory grandiosity delusions. She had personal history obsessive-compulsive disorder no previous admission an inpatient Unit. On psychotropic drugs condition failed improve, subsequently neurological symptoms developed. EEG abnormalities prompted lumbar puncture. In CSF strong plasma cell reaction atypical cells observed. The enzyme immunoassay for positive treatment penicillin signs remitted. Screening assessment followed thorough history, comprehensive clinical exam, systems, mental status exam physical relevant patient’s complaints findings judgment, pattern recognition knowledgeable interpretation laboratory facilitates diagnosis. Psychotropics antibiotics may help improve functioning prevent further progression. Conclusions relatively rare, but awareness association between neuropsychiatric presentations can understanding causes illness result more effective prevention, treatment. Disclosure No significant relationships.