{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:39:54Z","timestamp":1780472394196,"version":"3.54.1"},"reference-count":15,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>A 66-year-old woman presented with severe shooting pains throughout her back and legs, followed by progressive deafness, weight loss and headache. She had a history of marginal zone B-cell lymphoma stage IV-B, for which she was successfully treated with immunochemotherapy and rituximab maintenance therapy. A relapse was suspected, but chemotherapy was not administered, since, despite elaborate investigations, malignancy could not be proven. Because of a history of tick bites she was tested for antibodies against <jats:italic>Borrelia burgdorferi<\/jats:italic> in serum and cerebrospinal fluid (CSF), which were negative. However, a <jats:italic>B burgdorferi<\/jats:italic> PCR on CSF came back positive. The patient was treated for seronegative Lyme neuroborreliosis with ceftriaxone intravenously and dramatically improved. This case presentation demonstrates that, in immunocompromised patients, it is important not to solely rely on antibody testing and to use additional diagnostic tests to avoid missing or delaying the diagnosis.<\/jats:p>","DOI":"10.1136\/bcr-2012-007627","type":"journal-article","created":{"date-parts":[[2013,2,15]],"date-time":"2013-02-15T00:59:00Z","timestamp":1360889940000},"page":"bcr2012007627","source":"Crossref","is-referenced-by-count":19,"title":["Seronegative lyme neuroborreliosis in a patient using rituximab"],"prefix":"10.1136","volume":"2013","author":[{"given":"Willemijn Alexandra","family":"van Dop","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Academic Medical Center, Amsterdam, The Netherlands"},{"name":"Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Jos\u00e9","family":"Kersten","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands"},{"name":"Department of Hematology, Academic Medical Center, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bob","family":"de Wever","sequence":"additional","affiliation":[{"name":"Department of Molecular Bacteriology, Academic Medical Center, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joppe Willem","family":"Hovius","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands"},{"name":"Department of Infectious Diseases, Academic Medical Center, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2013,2,14]]},"reference":[{"key":"2025082801145782000_2013.feb14_1.bcr2012007627.1","doi-asserted-by":"publisher","DOI":"10.1086\/508667"},{"key":"2025082801145782000_2013.feb14_1.bcr2012007627.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199511163332004"},{"key":"2025082801145782000_2013.feb14_1.bcr2012007627.3","doi-asserted-by":"publisher","DOI":"10.1007\/s100960050381"},{"key":"2025082801145782000_2013.feb14_1.bcr2012007627.4","doi-asserted-by":"publisher","DOI":"10.1007\/s004150050216"},{"key":"2025082801145782000_2013.feb14_1.bcr2012007627.5","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000269672.17807.e0"},{"key":"2025082801145782000_2013.feb14_1.bcr2012007627.6","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1128\/jcm.26.2.338-346.1988","article-title":"Measurement of antibodies to the Borrelia burgdorferi flagellum improves serodiagnosis in Lyme disease","volume":"26","author":"Hansen","year":"1988","journal-title":"J Clin Microbiol"},{"key":"2025082801145782000_2013.feb14_1.bcr2012007627.7","first-page":"101","article-title":"Tired of Lyme borreliosis. 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