Untreated Neuroborreliosis presenting with somatic delusionsand subjective memory impairment
Bibliographic record
Abstract
Lyme disease is a tick-borne spirochete illness with multi systemic involvement. Al- though its neurological manifestations are becoming increasingly well recognized, its psychiatric presentations are not well known. Physicians who treat patients with lyme disease need to be aware of its neuropsychiatric symptoms, which may emerge months to years after the initial infection. Prompt diagnosis and effective treatment are needed to avoid the debilitating and possibly irreversible mental illness associated with the neuropsychiatric involvement of the disease. It has been reported that the areas of the United States with the highest prevalence of lyme disease also have the highest rate of schizophrenia. We report a case of a 63-year-old male with psychiatric history of distorted thought content, detachment from reality and somatic delusions. He reported delusions of being poisoned seven years ago which caused damage to all his body with residual poison in the fat cells despite self treating with various antioxidants, multivitamins and over the counter hepatic cleansers. Patient had history of being seen by multiple specialties including cardiologist, orthopedic surgeon, infectious disease specialist, pain specialist and different internists believing they are not able to understand the effects of poison on his body. During psychiatric evaluation the patient exhibited personality changes, disinhibited behavior and mild memory impairment. In spite of acceptable scores on mini mental status exam and Montreal cognitive assessment, patient scored borderline on Frontal lobe battery assessment. Thorough medical work up was completed and he was found to have hyperintensity in frontal lobe on brain MRI. Spinal tap was done which was within normal limit. Complete Serology testing was remarkable for lyme antibody IgG. He was started on a course of doxycycline and following completion of antibiotic therapy the patient showed significant improvement in his delusions.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".