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Infectious Mononucleosis and Lyme Disease as Confounding Diagnoses: A Report of 2 Cases

Trever M Koester1,2, Jennifer K Meece2, Thomas R Fritsche3,4

  • 1University of Wisconsin-Stout, Menomonie, WI, USA.

Clinical Medicine & Research
|September 1, 2018
PubMed

Insights

Concurrent Lyme disease and infectious mononucleosis are rare, complicating diagnosis due to similar symptoms and cross-reactive tests. This report details two children with Lyme disease, one possibly co-infected with Epstein-Barr virus (EBV).

Area of Science:

  • Pediatric Infectious Diseases
  • Immunology
  • Microbiology

Background:

  • Lyme disease and infectious mononucleosis (caused by Epstein-Barr virus, EBV) are common childhood illnesses.
  • Both conditions can present with overlapping symptoms, making accurate diagnosis challenging.
  • Serologic assays for Lyme disease and EBV can exhibit cross-reactivity, further complicating differential diagnosis.

Observation:

  • This study describes two pediatric cases presenting with confirmed early Lyme disease.
  • Both children exhibited clinical features suggestive of infectious mononucleosis.
  • One case involved a probable co-infection with both Lyme disease and EBV.

Findings:

  • The report highlights the diagnostic challenges posed by concurrent Lyme disease and EBV infections.
  • Cross-reactivity in serologic testing can lead to misdiagnosis or delayed diagnosis.
  • This is the first reported series of concurrent acute Lyme disease and EBV infection in children.

Implications:

  • Clinicians should consider the possibility of co-infection when patients present with overlapping symptoms of Lyme disease and infectious mononucleosis.
  • Awareness of potential cross-reactivity in diagnostic assays is crucial for accurate patient management.
  • Further research may be needed to elucidate the epidemiology and clinical impact of these co-infections.
Keywords:
Borrelia burgdorferiCo-infectionEpstein-Barr virusInfectious mononucleosisLyme disease

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