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Acute lyme infection presenting with amyopathic dermatomyositis and rapidly fatal interstitial pulmonary fibrosis: a case report.

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Abstract

INTRODUCTION:

Dermatomyositis has been described in the setting of
lyme infection in only nine previous case reports. Although
lyme disease is known to induce typical clinical findings that are observed in various collagen vascular diseases, to our knowledge, we believe that our case is the first presentation of acute
lyme disease associated with amyopathic dermatomyositis, which was then followed by severe and fatal interstitial pulmonary fibrosis only two months later.

CASE PRESENTATION:

We present a case of a 64-year-old African-American man with multiple medical problems who was diagnosed with acute
lyme infection after presenting with the pathognomonic rash and confirmatory serology. In spite of appropriate antimicrobial therapy for
lyme infection, he developed unexpected amyopathic dermatomyositis and then interstitial lung
disease.

CONCLUSIONS:

This case illustrates a potential for
lyme disease to produce clinical syndromes that may be indistinguishable from primary connective tissue diseases. An atypical and sequential presentation (dermatomyositis and interstitial lung
disease) of a common
disease (
lyme infection) is discussed. This case illustrates that in patients who are diagnosed with
lyme infection who subsequently develop atypical muscular, respiratory or other systemic complaints, the possibility of severe rheumatological and pulmonary complications should be considered.

J Med Case Rep. 2010 Jun 21;4:187. doi: 10.1186/1752-1947-4-187.

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