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无皮肤症状情况下莱姆病神经螺旋体病的揭示

Unveiling Lyme Neuroborreliosis in the Absence of Dermatological Symptoms.

作者信息

Almatroud Lanah, Saleh Alyaa, Sheikh Jibran A

机构信息

College of Human Medicine, Michigan State University, East Lansing, USA.

College of Medicine, Central Michigan University, Saginaw, USA.

出版信息

Cureus. 2024 Dec 27;16(12):e76473. doi: 10.7759/cureus.76473. eCollection 2024 Dec.

Abstract

Lyme neuroborreliosis can present with isolated neurological manifestations, posing diagnostic challenges, especially in the absence of hallmark dermatological symptoms like erythema migrans. This case highlights a patient with isolated cervical radiculopathy due to Lyme neuroborreliosis, presenting without systemic features such as fever, arthralgia, or rash. The diagnosis was confirmed through serological testing, with positive findings on the Western blot. Comparisons with reported cases, including isolated urinary retention, bilateral neurosensory hearing loss, and Bannwarth syndrome, reveal the clinical heterogeneity of Lyme neuroborreliosis. Elevated inflammatory markers, tick exposure, and serological findings remain crucial for diagnosis. This case emphasizes the importance of clinical vigilance in endemic areas, as timely recognition and treatment are essential to prevent long-term complications.

摘要

莱姆病神经伯氏疏螺旋体病可表现为孤立的神经症状,带来诊断挑战,尤其是在没有游走性红斑等典型皮肤症状的情况下。本病例突出了一名因莱姆病神经伯氏疏螺旋体病导致孤立性颈神经根病的患者,其表现无发热、关节痛或皮疹等全身症状。通过血清学检测确诊,免疫印迹法结果呈阳性。与已报道病例(包括孤立性尿潴留、双侧神经感觉性听力丧失和班恩瓦特综合征)的比较揭示了莱姆病神经伯氏疏螺旋体病的临床异质性。炎症标志物升高、蜱虫暴露和血清学结果对诊断仍然至关重要。本病例强调了在流行地区临床警惕的重要性,因为及时识别和治疗对于预防长期并发症至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7997/11767964/46d13029ae28/cureus-0016-00000076473-i01.jpg

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