A Case of Undetected Neuroborreliosis in a 75-Year-Old Chinese Male

Case Reports in Infectious Diseases
Jenny LamichhaneRajanish Bobde

Abstract

Lyme disease is a multisystem infection caused by the spirochete Borrelia burgdorferi sensu stricto that manifests with characteristic symptoms in patients. Patients are identified based on their clinical symptoms and then diagnosed through enzyme-linked immunosorbent assay (ELISA), Western blot, and blood culture techniques. Here, we present the case of a 75-year-old, Northeast suburban resident complaining of unstable gait, high fevers, malaise, myalgia, and confusion. This patient's symptoms were nonspecific, and his lab titers and blood cultures were repeatedly negative during his stay. It was only late in the course of his treatment that blood titers and cerebrospinal fluid analysis were positive for Lyme IgG and IgM. He was treated with intravenous doxycycline and prescribed oral doxycycline on discharge, resulting in a full recovery. We express the need for physicians to consider Lyme disease in endemic patients presenting with nonspecific systemic signs.

References

Jun 27, 2014·Arthritis & Rheumatology·Linda K Bockenstedt, Gary P Wormser
May 23, 2015·Infectious Disease Clinics of North America·Adriana R Marques
Nov 26, 2015·Revue Scientifique Et Technique·B Chomel
Jan 21, 2016·Case Reports in Neurological Medicine·Mohamad AlmoussaChristoph W Zimmermann
Mar 10, 2016·Case Reports in Neurological Medicine·Ahmet Z Burakgazi, Carl S Henderson
Apr 27, 2016·JAMA : the Journal of the American Medical Association·Edgar SanchezLinden T Hu
May 3, 2016·Annals of Internal Medicine·Linden T Hu

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Methods Mentioned

BETA
X-ray
ELISA

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