Lyme disease: Case report and review of the literature

Abstract

Lyme disease is a multisystem disorder which is transmitted by spirochetes. It appears following the incubation period lasting 3 to 32 days and the skin is the organ most commonly affected. Here, we report a patient presenting to the emergency department with Lyme-related signs and symptoms and diagnosed somewhat lately with detailed examination. A 72 years-old woman from Germany was admitted to the emergency department with the complaints of drowsiness and fever for two days persisting despite she was on antibiotics. She was admitted to the chest ward with the diagnosis of pneumonia after evaluation. Although ampicillin-sulbactam was administered, the fever continued. On physical examination, erythematous maculopapular rash was identified on the patient’s thigh and a tick was detected in this region. After clinical relief associated with the treatment of doxycycline, the patient was discharged from the hospital. A detailed history should be obtained from the patients and a thorough examination undertaken by the physicians staffed in the emergency departments or primary care units. Lyme disease should be considered in the differential diagnosis of patients with fever associated with cutaneous findings, especially of those who had been in close contact with cattle etc.