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Coma falsely attributed to Lyme disease.

Partam Manalai¹, Ravikumar M Bhalavat, Michael R Dobbs

¹University of Louisville School of Medicine, Department of Psychiatry and Behavioral Science, KY 40202, USA.

The Journal of the Kentucky Medical Association

|September 10, 2008

Summary

This summary is machine-generated.

Neuroborreliosis is rare in Kentucky, and Lyme disease rarely causes coma. Misdiagnosis occurred due to a lack of confirmatory testing, highlighting the need for careful diagnosis of uncommon diseases.

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Area of Science:

Neurology
Infectious Diseases
Medical Diagnostics

Background:

Neuroborreliosis, a neurological manifestation of Lyme disease, is infrequently diagnosed in North America.
The prevalence of Lyme disease and its neurological complications is notably low in regions like Kentucky.

Observation:

A patient in Kentucky presented with coma, initially diagnosed with Lyme disease based on clinical symptoms and a positive ELISA test.
Brain imaging revealed inflammatory changes consistent with neurological involvement.

Findings:

The initial diagnosis of Lyme disease was erroneous due to the lack of confirmatory testing.
Essential confirmatory tests include Western Blot, polymerase chain reaction (PCR), or real-time polymerase chain reaction (RT-PCR).

Implications:

Physicians must exercise caution when diagnosing rare conditions in areas with low prevalence.
Thorough differential diagnosis and confirmatory testing are crucial, particularly for nonclassical presentations of neuroborreliosis.