title: Coma falsely attributed to Lyme disease.
abstract: Neuroborreliosis has very low prevalence in Kentucky and coma due to Lyme disease is uncommon in North America. A patient diagnosed with Lyme disease in Kentucky, based on coma, typical inflammatory changes on brain imaging, and a positive ELISA resulted in an erroneous clinical impression. Diagnosis should have been confirmed by a positive result on Western Blot, polymerase chain reaction (PCR), or real-time polymerase chain reaction (RT-PCR) testing. Physicians must apply careful consideration before diagnosing a rare disease in areas where that condition is uncommon without first eliminating other differential options. Neuroborreliosis clinicalfindings are nonspecific and often require confirmatory testing, especially in nonclassical case presentations.
authors.affiliation: University of Louisville School of Medicine, Department of Psychiatry and Behavioral Science, KY 40202, USA.
authors.forename: Partam
authors.initials: P
authors.lastname: Manalai
authors.forename: Ravikumar M
authors.initials: RM
authors.lastname: Bhalavat
authors.forename: Michael R
authors.initials: MR
authors.lastname: Dobbs
authors.forename: Steven
authors.initials: S
authors.lastname: Lippmann
mesh_terms: D000328:Adult; D003128:Coma / Q000175:diagnosis / Q000209:etiology*; D003951:Diagnostic Errors; D006801:Humans; D007629:Kentucky; D008193:Lyme Disease / Q000150:complications*; D008297:Male; D012307:Risk Factors