Early disseminated cutaneous Lyme disease with SIADH, transaminitis, and pancytopenia: A case report

Lyme disease is a tick-borne disease predominantly caused by Borrelia burgdorferi in Canada. Early disseminated disease is challenging to diagnose and requires treatment to prevent severe sequelae. We report the case of a 71-year-old woman who was admitted for a fever. Her blood tests showed a syndrome of antidiuretic hormone secretion, transaminitis, and pancytopenia. During hospitalization, the patient was noted to have an initial annular patch, which was followed by multiple diffuse erythematous patches. After a comprehensive medical history by a dermatology consultant highlighting an exposure to a tick bite, early disseminated disease was diagnosed, and a complete remission was obtained with Doxycycline. Dermatologists must maintain a high clinical suspicion for Lyme disease.