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To report a case of
Lyme disease that presented with a single nummular unilateral interstitial keratitis.
Case report and review of the literature.
A 57-year-old black man who had contact with freshly killed deer had a chief complaint of foreign-body sensation in his right eye (OD) that had been diagnosed and treated for herpes simplex stromal keratitis. The patient underwent a systemic workup for interstitial keratitis. All results including RPR and MHA-TP were negative except for
Lyme antibody titer (enzyme-linked immunosorbent assay [ELISA]) 178 U/ml (normal, <159 U/ml).
Interstitial keratitis from
Lyme disease has been regarded as a bilateral
disease in the literature. We present this infrequent ocular manifestation of
Lyme disease as a rare single nummular unilateral presentation.