Coma falsely attributed to Lyme disease.
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.
Manalai
Partam
P
University of Louisville School of Medicine, Department of Psychiatry and Behavioral Science, KY 40202, USA.
Bhalavat
Ravikumar M
RM
Dobbs
Michael R
MR
Lippmann
Steven
S
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