[Comatose state--think different]

Praxis (Bern 1994). 2012 May 9;101(10):669-72. doi: 10.1024/1661-8157/a000937.
[Article in German]


We report the case of a 76-year old woman, who presented with signs of a meningoencephalitis. The result of lumbar puncture showed a mononuclear pleocytosis. Empirical antimicrobial treatment was promptly initiated. Nevertheless a comatose state complicated the clinical course. The diagnosis of neuroborreliosis was made serologically and by molecular biology. Under adequate therapy with intravenous ceftriaxone the patient showed a slow but full recovery. This case illustrates that potentially reversible diseases need very careful decision making regarding therapeutic activities and that neuroborreliosis is a potentially reversible cause of severe neurologic impairment.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Ceftriaxone / administration & dosage
  • Coma / drug therapy
  • Coma / etiology*
  • Diagnosis, Differential
  • Female
  • Humans
  • Infusions, Intravenous
  • Lyme Neuroborreliosis / diagnosis*
  • Lyme Neuroborreliosis / drug therapy
  • Lymphocytosis / drug therapy
  • Lymphocytosis / etiology*
  • Meningitis / drug therapy
  • Meningitis / etiology*
  • Tomography, X-Ray Computed


  • Anti-Bacterial Agents
  • Ceftriaxone