Duong Michael Tran, Shah Manish, Serhiyenia Tatsiana, Pandya Rani, Subedi Ashish, Bhimineni Charishma, Duong Melissa T, Heayn Michelle, Ibrahim Tanya, Stefanelli Gina, Patel Mudita
Department of Medicine, Jefferson Einstein Healthcare Network, Greater Philadelphia, PA 19403, United States.
Department of Medicine, University of Pennsylvania Health System, Philadelphia, PA 19104, United States.
BJR Case Rep. 2025 Mar 20;11(2):uaaf022. doi: 10.1093/bjrcr/uaaf022. eCollection 2025 Mar.
Among the causes of ambulatory dysfunction, Lyme polyradiculitis is an uncommon but still essential aetiology to consider given its simple, effective treatment. We present a case of a man with 1 month of worsening bilateral leg paresis, paresthesia, and pain. He recalled no erythema migrans or tick bite. Initial screening showed negative serum Lyme and positive Epstein-Barr Virus testing. At our hospital, MRI revealed polyradiculitis with cauda equina nerve root enhancement. Subsequent serum and cerebrospinal results were positive for Lyme neuroborreliosis. He improved rapidly from a course of doxycycline. This case highlights the importance of timing for Lyme serologies in early neuroborreliosis, as well as converging clinical, radiological, and biofluid testing for diagnosis and management.
在门诊功能障碍的病因中，莱姆多发性神经根炎虽不常见，但鉴于其治疗简单有效，仍是一个需要考虑的重要病因。我们报告一例男性患者，其双侧腿部无力、感觉异常和疼痛持续加重1个月。他回忆不起有游走性红斑或蜱叮咬史。初步筛查显示血清莱姆检测阴性，EB病毒检测阳性。在我院，磁共振成像（MRI）显示多发性神经根炎伴马尾神经根强化。随后的血清和脑脊液检测结果显示莱姆神经疏螺旋体病呈阳性。他在接受一个疗程的强力霉素治疗后迅速好转。该病例强调了早期神经疏螺旋体病中莱姆血清学检测时机的重要性，以及综合临床、影像学和生物流体检测用于诊断和治疗的重要性。
