Lyme disease causes mixture of signs, together with autonomic dysfunction

Within the case report “A Affected person with SIADH, Urinary Retention, Constipation, and Bell’s Palsy following a Tick Chunk,” Leone and colleagues describe a affected person who developed an uncommon mixture of Lyme disease signs, all of which resolved following therapy. [1]

“Our case emphasizes that Lyme disease is able to inflicting a mixture of signs, which can be tough to interpret, resulting in a delay in analysis,” the authors write. And these signs could “develop consecutively additional obscuring the medical image.”

A 69-year-old male offered to the hospital with stomach ache and hyponatremia, a situation that happens when the extent of sodium within the blood is simply too low.

4 weeks earlier the person seen a rash on his elbow, which resolved after one week. He additionally developed a decreased urge for food, anorexia, stomach fullness, chills, headache, fatigue, and myalgias and complained of getting an acute onset of constipation.

“There must be a excessive alert of atypical presentation of this widespread tick chew related an infection,” the authors write.

Testing for Lyme disease was constructive, and the affected person started therapy with IV ceftriaxone.

A number of days later, he developed Bell’s palsy, together with urinary retention, which required catheterization.

“Our case highlights the significance of together with neurological Lyme disease as a attainable analysis in people who current with signs of autonomic dysregulation….”

Two days after antibiotic therapy was initiated, the affected person developed signs believed to be resulting from a Herxheimer response. The authors write, “the affected person was discovered to be tachycardic, weak, diaphoretic, and febrile.”

Take a look at outcomes “steered that Lyme carditis and NSTEMI have been unlikely, and that these signs could possibly be a Jarisch–Herxheimer response.” He was then switched to IV doxycycline.

At his 3-month follow-up appointment, the person’s signs had resolved fully.

“In our affected person, a particularly uncommon mixture of signs together with SIADH, urinary retention, and constipation along with facial neuritis was noticed.”

SIADH also referred to as syndrome of inappropriate antidiuretic hormone secretion is a situation by which excessive ranges of a hormone trigger the physique to retain water.

Authors conclude: 

“Our case highlights the significance of together with neurological Lyme disease as a attainable analysis in people who current with signs of autonomic dysregulation corresponding to hyponatremia resulting from an SIADH-like syndrome, urinary retention, anorexia, constipation, and facial palsy.”