Iwata Kentaro, Shimada Tomoe, Kawabata Hiroki
Division of Infectious Diseases, Kobe University Hospital.
Kansenshogaku Zasshi. 2013 Jan;87(1):44-8. doi: 10.11150/kansenshogakuzasshi.87.44.
A 42-year-old woman presenting with years of fever and vague symptoms could not be satisfactorily diagnosed in physical examination or conventional workups. She was presumptively diagnosed with chronic fatigue syndrome and treated symptomatically. Fourteen months after the initial visit, she developed left facial palsy. Lyme disease serology was positive. Four weeks of oral amoxicillin ameliorated symptoms. Only 5 to 15 cases of Lyme disease are reported annually in Japan, mostly from the northeastern-most island of Hokkaido. It may occur anywhere in Japan, however; probably is underdiagnosed. Lyme disease may cause fevers of unknown origin. Astute clinical suspicion and appropriate workups are thus needed to diagnose this infection.
一名42岁女性，多年来一直发烧且伴有模糊不清的症状，体格检查或常规检查均未能做出令人满意的诊断。她被初步诊断为慢性疲劳综合征并接受了对症治疗。初诊14个月后，她出现了左侧面神经麻痹。莱姆病血清学检查呈阳性。口服阿莫西林四周后症状有所改善。在日本，每年仅报告5至15例莱姆病病例，大部分来自最东北端的北海道岛。然而，该病可能在日本任何地方发生；很可能存在诊断不足的情况。莱姆病可能导致不明原因的发热。因此，需要敏锐的临床怀疑和适当的检查来诊断这种感染。
