Meningitis, cranial neuritis, and radiculoneuritis associated with Borrelia burgdorferi infection in a horse.
Abstract: A 12-year-old Thoroughbred was examined because of signs of depression, neck stiffness, and poor performance. Results: Physical examination revealed that the horse was dull, appeared depressed, was reluctant to raise its neck and head above a horizontal plane, and had a temperature of 38.5°C (101.3°F). No radiographic or scintigraphic abnormalities of the neck were found; however, high plasma fibrinogen concentration and relative lymphopenia were identified and the horse was seropositive for antibodies against Borrelia burgdorferi. Analysis of CSF revealed neutrophilic inflammation, and results of a PCR assay of CSF for B burgdorferi DNA were positive. Immunologic testing revealed severe B-cell lymphopenia and a low serum IgM concentration consistent with common variable immunodeficiency. Results: The horse responded well to do×ycycline treatment (10 mg/kg [4.5 mg/lb], PO, q 12 h for 60 days) and returned to normal exercise. However, 60 days after treatment was discontinued, the horse again developed a stiff neck and rapidly progressive neurologic deficits, including severe ataxia and vestibular deficits. The horse's condition deteriorated rapidly despite IV oxytetracycline treatment, and the horse was euthanatized. Postmortem examination revealed leptomeningitis, lymphohistiocytic leptomeningeal vasculitis, cranial neuritis, and peripheral radiculoneuritis with Wallerian degeneration; findings were consistent with a diagnosis of neuroborreliosis. Conclusions: Nervous system infection with B burgdorferi should be considered in horses with evidence of meningitis and high or equivocal serum anti-B burgdorferi antibody titers. Evaluation of immune function is recommended in adult horses evaluated because of primary bacterial meningitis.
Publication Date: 2010-11-16 PubMed ID: 21073390DOI: 10.2460/javma.237.10.1180Google Scholar: Lookup
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Summary
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This study describes the case of a 12-year-old horse that showed neurological signs linked to an infection with Borrelia burgdorferi, the bacteria causing Lyme disease. The horse initially improved with treatment but later showed severe neurological deficits and was euthanized. Findings were consistent with neuroborreliosis, suggesting that neurological symptoms in horses with Lyme disease should be taken seriously.
Case Presentation and Initial Diagnosis
- The subject of this study was a 12-year-old Thoroughbred horse showing signs of depression, neck stiffness, and poor performance.
- Physical examination revealed the horse appeared depressed, reluctant to lift its neck and head, and had a slight fever. Despite no abnormal findings on neck imaging, bloodwork indicated high levels of fibrinogen, a protein that indicates inflammation, and a low number of lymphocytes, a type of white blood cell, suggesting the horse was suffering from an infection.
- The horse tested positive for antibodies against Borrelia burgdorferi, the bacteria that causes Lyme disease, leading to the initial diagnosis of this condition.
Treatment and Further Developments
- The horse was then treated with doxycycline, an antibiotic usually effective against Borrelia burgdorferi, for 60 days. The horse initially recovered well and resumed normal activities.
- However, 60 days after cessation of treatment, the horse showed recurrence of neck stiffness as well as rapidly progressive neurological signs, including severe lack of coordination (ataxia) and balance problems (vestibular deficits).
- Despite treatment with another type of antibiotic (oxytetracycline), the horse’s condition worsened and the decision was made to euthanize the animal.
Postmortem Findings and Conclusions
- A postmortem examination revealed signs of multiple types of inflammation and damage to the nervous system, consistent with neuroborreliosis, a severe form of Lyme disease affecting the nervous system.
- The researchers concluded that an infection with Borrelia burgdorferi should be a consideration in horses showing signs of meningitis along with positive or ambiguous anti-Borrelia burgdorferi antibody levels.
- Additionally, they recommended assessing immune function in adult horses showing signs of primary bacterial meningitis.
In summary, this case study underscores the importance of taking neurological symptoms in horses seriously when Lyme disease is suspected, as the consequences of neuroborreliosis can be severe and potentially fatal.
Cite This Article
APA
James FM, Engiles JB, Beech J.
(2010).
Meningitis, cranial neuritis, and radiculoneuritis associated with Borrelia burgdorferi infection in a horse.
J Am Vet Med Assoc, 237(10), 1180-1185.
https://doi.org/10.2460/javma.237.10.1180 Publication
Researcher Affiliations
- Department of Clinical Studies, University of Pennsylvania, PA 19348, USA. franjames@donningtongrove.com
MeSH Terms
- Animals
- Anti-Bacterial Agents / therapeutic use
- Borrelia burgdorferi
- Doxycycline / therapeutic use
- Horse Diseases / drug therapy
- Horse Diseases / etiology
- Horse Diseases / microbiology
- Horses
- Lyme Disease / complications
- Lyme Disease / drug therapy
- Lyme Disease / veterinary
- Male
- Meningitis / etiology
- Meningitis / veterinary
- Neuritis / etiology
- Neuritis / veterinary
- Radiculopathy / etiology
- Radiculopathy / veterinary
Citations
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