Presentation of Stroke and Lyme Disease

Cureus, (Sathi S., et al.) published “Ischemic Stroke With Hemorrhagic Conversion in a Case of Lyme Neuroborreliosis” on August 15, 2022. Authors present a case study of a patient (59-year-old male and resident of Michigan) with ischemic stroke and hemorrhagic conversion, who also had a positive serology for Lyme neuroborreliosis. The man was admitted to a hospital while visiting Florida.

The patient presented with ischemic stroke, having difficulty with communication and confusion for two days. Imaging of the patient’s brain showed a “subacute infarct in the left parietal lobe” and white matter signal abnormalities in multiple areas of his brain. Cerebral spinal fluid testing also revealed positive serology for Borrelia burgdorferi (both IgM and IgG antibodies).

The patient was treated with 30 days of IV ceftriaxone and responded with what authors observed as significant clinical improvement. 

Authors report that there are few documented cases of Lyme disease associated with stroke, making diagnosis more and standard treatment protocols difficult. They suggest that in areas where Lyme disease is considered endemic, neuroborreliosis should be considered in the differential diagnosis for patients who manifest with stroke or sudden confusion.

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