Lyme Disease Presenting Research Articles

Lyme disease misdiagnosed as a temporomandibular joint disorder

Craniomandibular disorders cause many pleomorphic and seemingly unrelated clinical manifestations that mimic other more serious medical problems and thus can present physicians and dentists with a challenge that invites misdiagnosis and improper treatment planning. Conversely, misdiagnosis and ineffective treatment planning are facilitated when serious medical problems manifest a range of signs and symptoms that are clinically similar to temporomandibular joint muscle dysfunction. At times, the patient's response to therapy may be the best method of corroborating a diagnosis, as illustrated in this report of a patient with Lyme disease that was misdiagnosed as a temporomandibular joint disorder. Lyme disease has already reached epidemic proportions in several parts of the United States and its geographic distribution is spreading. Because Lyme disease is a life-threatening illness whose clinical manifestations can mimic temporomandibular joint/myofascial pain-dysfunction, it is the responsibility of every dentist who treats craniomandibular disorders to become familiar with the clinical presentations of Lyme disease and more proficient in its differential diagnosis.

Complete heart block as the sole presentation of Lyme disease

Complete heart block as the sole presentation of Lyme disease

Complete Heart Block as the Sole Presentation of Lyme Disease

We report a case of Lyme myocarditis presenting solely as complete heart block in a previously healthy 32-year-old white man. Indium cardiac antimyosin scan showed diffuse uptake (2+, on a scale of 0 to 4+) during the acute phase of the illness. The electrocardiogram and the indium cardiac antimyosin scan were normal 6 weeks after completion of tetracycline and prednisone treatment. Lyme carditis should be considered in the differential diagnosis of complete heart block of unclear origins, even in patients presenting without other signs or symptoms suggestive of Lyme disease.

Late cutaneous lyme disease: Acrodermatitis chronica atrophicans

Acrodermatitis chronica atrophicans (ACA) is a chronic skin disorder characterized in its initial stages by an edematous infiltration that progresses to an atrophic lesion resembling localized scleroderma in its more established form [l]. It has been recognized more commonly in Europe than in the United States for many years and is known to be linked epidemiologically with the tick Zxodes ricinus and the skin lesion erythema chronicum migrans [2,3]. Recent serologic studies from Sweden have demonstrated an association between ACA and the presence of antibodies against the Lyme disease spirochete Borrelia burgdorferi [3,43. This entity is seldom recognized in North America and there has been only one report of ACA as a late manifestation of Lyme disease in the United States [5]. We describe herein two patients who presented with ACA as their principal manifestation of B. burgdorferi infection in an endemic region of Lyme disease on eastern Long Island, New York. These patients represent the first reported cases of Lyme disease presenting with ACA in North America.

FACIAL PALSY ASSOCIATED WITH LYME DISEASE.

One of the less common presentations of Lyme disease is a facial-nerve palsy that can be mistaken for Bell's palsy. This author describes the case histories of nine patients who presented …

Lyme Disease Presenting as Seronegative Rheumatoid Arthritis

Lyme Disease Presenting as Seronegative Rheumatoid Arthritis