Abstract
IntroductionDermatomyositis has been described in the setting of lyme infection in only nine previous case reports. Although lyme disease is known to induce typical clinical findings that are observed in various collagen vascular diseases, to our knowledge, we believe that our case is the first presentation of acute lyme disease associated with amyopathic dermatomyositis, which was then followed by severe and fatal interstitial pulmonary fibrosis only two months later.Case presentationWe present a case of a 64-year-old African-American man with multiple medical problems who was diagnosed with acute lyme infection after presenting with the pathognomonic rash and confirmatory serology. In spite of appropriate antimicrobial therapy for lyme infection, he developed unexpected amyopathic dermatomyositis and then interstitial lung disease.ConclusionsThis case illustrates a potential for lyme disease to produce clinical syndromes that may be indistinguishable from primary connective tissue diseases. An atypical and sequential presentation (dermatomyositis and interstitial lung disease) of a common disease (lyme infection) is discussed. This case illustrates that in patients who are diagnosed with lyme infection who subsequently develop atypical muscular, respiratory or other systemic complaints, the possibility of severe rheumatological and pulmonary complications should be considered.
Highlights
Dermatomyositis has been described in the setting of lyme infection in only nine previous case reports
This case illustrates a potential for lyme disease to produce clinical syndromes that may be indistinguishable from primary connective tissue diseases
An atypical and sequential presentation of a common disease is discussed. This case illustrates that in patients who are diagnosed with lyme infection who subsequently develop atypical muscular, respiratory or other systemic complaints, the possibility of severe rheumatological and pulmonary complications should be considered
Summary
Prognosis of dermatomyositis is related to severity of myopathy, related end organ damage, and coexistent malignancy [11,12]. We describe a patient with acute lyme infection who presents with amyopathic dermatomyositis and rapidly progressive interstitial fibrosis. This case illustrates a potential for lyme disease to produce clinical. Syndromes and fatal complications that may be indistinguishable from those observed in primary connective tissue diseases The corollary of this proposition is that in patients who are diagnosed with lyme infection who subsequently develop atypical muscular, respiratory or other systemic complaints, the possibility of severe rheumatological and pulmonary associations should be considered. Authors' contributions HN, lead and corresponding author, managed this patient clinically, and helped to draft the manuscript and obtain the literature review. HN helped to draft the manuscript and obtain the literature review.
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