Multifocal choroiditis with evidence of Lyme disease.

A 32-year-old man had multifocal choroiditis without vitreous involvement. The diagnosis of Lyme disease was suggested by serial enzyme-linked immunosorbent assays of his serum and a cerebrospinal fluid specimen. The ocular findings resembled those seen in patients with acute posterior multifocal placoid pigment epitheliopathy (APMPPE). The active lesions resolved after administration of a two-week course of intravenous ceftriaxone. This case suggests that some cases of APMPPE actually may be Lyme disease.