An Unusual Presentation of Lyme disease In a Patient with Severe Abdominal Pain: A Case Report

Objective:

We present thoracic radiculopathy as the sole clinical sign of early disseminated neuroborreliosis.

Methods:

We report a case of a 40-year-old female with panhypopituitarism and a permanent ventriculoperitoneal drain who
experienced severe abdominal pain as a primary and isolated symptom of Lyme disease (LD).

Results:

To our knowledge, thoracic radiculopathy as an isolated neurological manifestation of LD has been presented before
only once. Radiculopathy is a well-known symptom of LD, but usually occurs in conjunction with additional neurological
symptoms. The diagnosis was supported by a self-reported abdominal skin lesion consistent with erythema migrans and by
additionally performed serological Borrelia tests.

Conclusion:

Although rare, thoracic radiculopathy may be an isolated symptom of early neuroborreliosis. Alternative diagnoses
have to be taken into account. As an additional learning point, doctors should be aware of the potential abrogation of the usual
evolution of the antibody response due to adequate treatment of the infection.