Da Porto Andrea, Battellino Michele, Colussi Gianluca, Di Piazza Vito, Sechi Leonardo
Clinica Medica, University of Udine, Udine, Italy.
Internal Medicine Department, Tolmezzo Hospital, Tolmezzo, Italy.
Eur J Case Rep Intern Med. 2019 Jul 24;6(8):001188. doi: 10.12890/2019_001188. eCollection 2019.
Tick-borne diseases (Lyme disease and tick-borne encephalitis) are becoming a major public health concern. Rapid and correct diagnosis is crucial for complicated cases but is often delayed because of low suspicion or unusual clinical presentation. In this paper the authors describe two atypical presentations of Lyme disease and tick-borne encephalitis in order to help clinicians resolve diagnostic challenges.
Tick -borne diseases canould have atypical presentations.In endemic areas, patients with unexplained and refractory hyponatremiaaemia, should be screened for Lyme disease even in the absence of elevatedion of inflammatory markers or other specific symptoms.Persistent hiccups could be an atypical clinical presentation of tick-borne encephalitis (TBE).
蜱传疾病（莱姆病和蜱传脑炎）正成为主要的公共卫生问题。对于复杂病例，快速准确的诊断至关重要，但由于怀疑度低或临床表现不寻常，诊断往往会延迟。在本文中，作者描述了莱姆病和蜱传脑炎的两种非典型表现，以帮助临床医生解决诊断难题。
蜱传疾病可能有非典型表现。在流行地区，即使炎症标志物未升高或没有其他特定症状，不明原因且难治性低钠血症的患者也应筛查莱姆病。持续性呃逆可能是蜱传脑炎（TBE）的非典型临床表现。
