In their article, “Lyme-Associated Pericarditis: A Case Report and Literature Review,” Ameer and colleagues describe an 18-year-old man who developed pericarditis due to Lyme disease.1 The patient who had a medical history of asthma, irritable bowel syndrome, and obsessive-compulsive disorder presented to the emergency department with complaints of chest pain. The pain was intense – 8 on a scale of 10 and located in the center of his chest. The pain woke him up from sleep and was associated with shortness of breath and palpitations. “The pain worsened with lying down, while taking deep breath ..read more

In their article, “Concurrent Infection of the Human Brain with Multiple Borrelia Species,” Golovchenko and colleagues describe the case involving a post-mortem brain autopsy on a man who suffered for more than 10 years with neurologic and psychiatric symptoms due to Lyme disease. The patient underwent repeated testing with “borderline positivity for Borrelia infection, followed by the prescription of several antibiotics, which provided no clinical improvements, followed by hospitalization at psychiatric clinics,” the authors state. CASE REPORT The 28-year-old patient visited his physician in ..read more

In their study, “Atypical Lyme Disease Rash: A Case Report,” Khanna et al. describe the case of a 69-year-old woman, who tested negative for Lyme disease (according to CDC criteria), yet presented with an atypical Lyme rash. “Our patient only had one band positive on Western blot testing, which is not considered a positive result.” “Most clinicians recognize [Lyme disease] by the typical associated bull’s-eye appearance of the erythema migrans (EM) rash. However, a diagnostic challenge occurs when an alternate appearance for the rash is present,” the authors state. In a study of 69 people, wh ..read more

Although North Carolina reportedly has some of the highest incidence rates of spotted fever rickettsiosis and ehrlichiosis, there have been fewer cases of Lyme disease reported – until recently. However, “many clinicians have limited experience with Lyme disease, and diagnostic errors are common,” Boyce et al. states. Cases of Lyme disease on the rise in North Carolina A woman in her late 60’s went bike riding in the suburbs north of Raleigh, North Carolina. “After the ride, she felt dehydrated, lightheaded, and excessively fatigued for the level of exertion,” the authors state. Four days lat ..read more

An 80-year-old man, later diagnosed with Lyme disease, was admitted to the hospital with left leg paresis [muscle weakness], along with pain and sensory disturbances in his left abdomen. He also had a rash on his left lower abdomen, severe abdominal pain and constipation. The symptoms had been ongoing for 4-5 weeks. The patient had visited three other medical centers for evaluation of his abdominal pain. However, a colonoscopy and CT scan of the abdomen did not explain the severity of the patient’s symptoms. The rash manifest as a “patchy, pruritic redness with pustules, which was particularl ..read more

According to the authors, diaphragm paralysis as a complication of Lyme disease was first reported in 1986. Since then, there have only been 4 cases involving bilateral paralysis of the diaphragm, which can cause breathing problems in patients.  “… the presented case will be the fifth described case of bilateral diaphragmatic paralysis in the course of probable Lyme neuroborreliosis.” Patients with this condition experience weakness of the diaphragm and “have reduced breathing capabilities or are unable to control their voluntary breathing. They also have difficulty maintaining adequate ..read more

The young woman was admitted to the emergency department with acute pleuritic chest pain and shortness of breath. (Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling.) The woman exhibited only mild tachycardia (100/min). However, “Considering the suspicion of acute myocarditis, the patient was admitted to an intensive cardiac care unit,” the authors state. During hospitalization, cardiac monitoring revealed several asymptomatic episodes of paroxysmal AV block, including second-degree Mobitz I AV block, second de ..read more

An 80-year-old man was admitted to a hospital in Pennsylvania, an area endemic for Lyme disease, due to increased weakness and confusion. He had “several days of nausea with decreased appetite, generalized malaise, fatigue, and weakness,” according to the authors. Cerebrospinal fluid (CSF) studies suggested aseptic meningitis. And a CT scan showed dilated ventricles. Treatment for normal pressure hydrocephalus relieved his symptoms. On the fourth day of hospitalization, the man tested positive for Lyme disease by Western blot on bands 23KD and 39KD. “Healthcare providers treating patients wit ..read more

In their article “Lyme Borreliosis as a Trigger for Autoimmune Disease,” Yehudina and colleagues present a unique case in which an infection with Borrelia burgdorferi (the bacteria which causes Lyme disease) triggered the autoimmune condition, systemic lupus erythematosus (SLE), also referred to as lupus.¹ As the authors point out, “long-term exposure of the host’s immune system to [Borrelia] spirochetes can contribute to the development of [a new onset] chronic autoimmune disease.” This case report describes a 35-year-old woman who developed pain in the joints of her hand, episodes of low-gr ..read more

In their article “Through the Eyes of Uncertainty: Giant Cell Arteritis and Lyme Neuroborreliosis in a Story of Vision Loss,” Wan and colleagues describe a unique case in which an elderly woman, who tested positive for both giant cell arteritis and Lyme disease, developed vision problems including an abrupt loss of vision.¹ An acute loss of vision and other vision problems can be caused by a variety of medical conditions including an autoimmune disorder known as giant cell arteritis (GCA). This is a type of vasculitis whereby certain arteries, particularly those near the temples, become infla ..read more