HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Rapid Responses: Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Morrison, C. Articles by Aucott, J. N. Search for Related Content PubMed Articles by Morrison, C. Articles by Aucott, J. N. Social Bookmarking                      What's this?

Unusual Presentation of Lyme Disease: Horner Syndrome with Negative Serology

From the Department of Medicine, Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland

Correspondence: Corresponding author: John N. Aucott, MD, Johns Hopkins at Greenspring Station, 10755 Falls Road, Suite 200, Lutherville, Maryland 21093 (E-mail: jaucott2{at}jhmi.edu)

Early disseminated Lyme disease can be difficult to diagnose because of atypical symptoms and physical findings. A clinical diagnosis must be made in the absence of confirmatory serologic testing to allow timely therapy. We report a case of a 69-year-old woman who presents with fever, Horner syndrome, and a 12-cm oval-shaped erythematous macular rash with multiple vesiculopustular eruptions. The patient recovered after appropriate intravenous antibiotics, but serologic testing only confirmed the diagnosis 4 weeks later. This case also describes an unusual complication involving the neurologic system. We illustrate the clinical presentation and review the medical literature. Lyme disease should always be considered in patients from endemic regions with viral-like symptoms or a new rash.

CiteULike

Complore

Connotea

Del.icio.us

Digg

Reddit

Technorati

This article has been cited by other articles:

				M. A. Bowman and A. V. Neale Women's Physical Health, Mental Health, and Practical Hints for Common Practice Issues J Am Board Fam Med, March 1, 2009; 22(2): 99 - 101. [Full Text] [PDF]