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Neurogenic bladder in lyme disease.


Lyme disease is a multi-systemic, tick-borne infectious
disease caused by a spirochete, Borrelia burgdorferi. Various urologic symptoms are associated with
Lyme disease, which can be primary or late manifestations of the
disease. Although voiding dysfunction is a rarely reported symptom in patients with
Lyme disease, it is one of the most disabling complications of
Lyme disease. Korea is not an endemic area of
Lyme disease, thus, fewer cases have been reported. Herein, we report a case of a 32-year-old man with rapidly progressive bilateral ptosis, dysphagia, spastic paraparesis, and voiding difficulty in whom
Lyme disease was diagnosed through serologic tests for antibodies and Western blot testing. A urodynamic study demonstrated detrusor areflexia and bulbocavernosus reflex tests showed delayed latency, indicating demyelination at S2-S4 levels. He received a 4-week course of intravenous ceftriaxone (2 g/day). The patient has recovered from the bilateral ptosis and spastic paraparesis but still suffers from neurogenic bladder.

Int Neurourol J. 2012 Dec;16(4):201-4. doi: 10.5213/inj.2012.16.4.201. Epub 2012 Dec 31. [1]