SERONEGATIVE CHRONIC RELAPSING NEUROBORRELIOSIS

We report an unusual patient with evidence of Borrelia burgdorferi inf ection who experienced repeated neurologic relapses despite aggressive antibiotic therapy. Each course of therapy was associated with a Jari sch-Herxheimer-like reaction. Although the patient never had detectabl e free antibodies to B. burgdorferi in serum or spinal fluid, the CSF was positive on multiple occasions for complexed anti-B. burgdorferi a ntibodies, B. burgdorferi nucleic acids and free antigen.