The authors report a case of fatal neuropsychiatric Lyme disease (LD)
that was expressed clinically by progressive frontal lobe dementia and
pathologically by severe subcortical degeneration. Antibiotic treatment
resulted in transient improvement, but the patient relapsed after the
antibiotics were discontinued. LD must be considered even in cases with
purely psychiatric presentation, and prolonged antibiotic therapy may be
necessary.
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