A Case of Post-Fever Retinitis in a Patient with Positive Lyme Borreliosis Serology

Abstract

Background: Lyme Borreliosis accounts for less than 1% of all uveitis cases. The challenge in diagnosing Lyme-associated uveitis in a seropositive patient is determining whether the serology status is causative or incidental. We describe a case that illustrates this challenge: a post-fever retinitis in a patient with persistent positive Lyme serology. Case Presentation: A patient presented to the eye clinic with complaints of blur and foreign body sensation in his right eye after getting sawdust in his eye. Further lab workup was only remarkable for Lyme IgG and IgM and the patient was subsequently diagnosed with a post-fever retinitis. Management and Outcomes: The patient was treated with oral prednisone, and a subsequent IOP spike was managed with topical ocular hypotensive drops until the course of steroid therapy was completed. The uveitis resolved over seven weeks. Conclusions: Post-fever retinitis is a diagnosis of exclusion, and diagnosis can be challenging in the presence of positive serology for other known causes of uveitis. This case highlights the importance of detailed case history and clinical findings in determining alternative causes of uveitis in patients with positive LB serology. CE Notification: This article is available as a COPE accredited CE course. You may take this course for 1-hour credit. Read the article and take the qualifying test to earn your credit. Click here to Enroll (https://www.crojournal.com/a-case-of-post-fever-retinitis-in-a-patient-with-positive-lyme-borreliosis-serology) Please check COPE course expiry date prior to enrollment. The COPE course test must be taken before the course expiry date.