Rare case of acute transverse myelitis associated with Lyme neuroborreliosis

Abstract

Acute transverse myelitis is a neurological disorder that leads to acute spinal cord injury due to inflammation caused by autoimmune disorders or by parainfectious etiologies. Among the many different infectious causes of transverse myelitis, one of the rare ones is Lyme disease. Here we describe a case of a 62 year old male who presents with bilateral paresthesia and weakness. MRI imaging of the cervical and thoracic spine led to the initial diagnosis of cervical cord edema leading to the symptoms associated transverse myelitis. However further workup of different infectious causes lead to positive Lyme titers with positive confirmatory ELISA testing. Initiation of Lyme disease treatment with IV ceftriaxone led to the gradual resolution of the symptoms.

Clinical and epidemiological features of Lyme neuroborreliosis in adults and factors associated with polyradiculitis, facial palsy and encephalitis or myelitis

“…The results of our study showed that the rarest and most severe manifestation of early LNB is myelitis, which can result in death due to complications. Despite the rare occurrence, we, like other authors 16,21 , suggest that every patient presenting aseptic encephalitis or myelitis has to be tested for B. burgdorferi s.l. in endemic areas because unfavorable outcomes are possible.…”

Clinical and epidemiological features of Lyme neuroborreliosis in adults and factors associated with polyradiculitis, facial palsy and encephalitis or myelitis

“…The results of our study showed that the rarest and most severe manifestation of early LNB is myelitis, which can result in death due to complications. Despite the rare occurrence, we, like other authors 15,20 , suggest that every patient presenting aseptic encephalitis or myelitis has to be tested for B. burgdorferi s.l. in endemic areas because unfavorable outcomes are possible.…”