Borrelia Hermsii Causing Relapsing Fever and Uveitis

Purpose: To describe a case of uveitis that is associated with Borrelia hermsii relapsing fever. Design: Interventional case report. Methods: A 12-year-old boy with two weeks of relapsing fevers 10 days after camping in remote eastern Oregon was examined. Borrelia hermsii immunoglobulin M and G levels were markedly elevated. Intravenous ceftriaxone, followed by four weeks of oral cephuroxime was administered, but the patient developed unilateral floaters and blurred vision in association with anterior and intermediate uveitis. Results: Doxycycline was administered for presumed residual infection. Four weeks later, the visual acuity had improved. The anterior chamber was quiet, and topical corticosteroid was tapered successfully. Conclusion: Although rare, Borrelia hermsii should be included in the list of spirochetal diseases that are associated with uveitis.