An unusual presentation of Lyme neuroborreliosis.
Back pain is a common symptom among patients presenting to the acute medical unit. We describe the case of a 55-year-old man with a brief history of fatigue and severe back pain, unresponsive to escalating doses of opiate analgesia. Blood tests and imaging studies were unremarkable and a functional diagnosis was considered. Several weeks into his admission he developed a lower motor neurone facial nerve palsy. He was treated with antibiotics for an incidental finding of a hospital-acquired pneumonia on imaging, which remarkably led to the resolution of his facial palsy and allowed a dramatic reduction in analgesia. This triggered further investigations; identifying Lyme neuroborreliosis as the cause of his symptoms.
Victoria Hospital, Kirkcaldy, Fife, Scotland.
L
L
Kitto
Victoria Hospital, Kirkcaldy, Fife, Scotland.
C
C
McKenna
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001416:Back Pain / Q000209:etiology*; D005158:Facial Paralysis / Q000209:etiology*; D006801:Humans; D020852:Lyme Neuroborreliosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged
D000900:Anti-Bacterial Agents