Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Jun 21;4:187.
doi: 10.1186/1752-1947-4-187.

Acute Lyme Infection Presenting With Amyopathic Dermatomyositis and Rapidly Fatal Interstitial Pulmonary Fibrosis: A Case Report

Affiliations
Free PMC article

Acute Lyme Infection Presenting With Amyopathic Dermatomyositis and Rapidly Fatal Interstitial Pulmonary Fibrosis: A Case Report

Hien Nguyen et al. J Med Case Rep. .
Free PMC article

Abstract

Introduction: Dermatomyositis 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 presentation: We 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.

Conclusions: 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 (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.

Figures

Figure 1
Figure 1
Mechanic's hands in a patient with dermatomyositis. Image reprinted with permission from emedicine.com, 2009. Available at: http://emedicine.medscape.com/article/1064945-overview
Figure 2
Figure 2
Vacuolar changes of columnar epithelium and lymphocytic inflammatory infiltrates at the dermal-epidermal interface in dermatomyositis. Image reprinted with permission from emedicine.com, 2009. Available at: http://emedicine.medscape.com/article/1064945-overview.
Figure 3
Figure 3
Interstitial pulmonary fibrosis in our patient's computed tomography scan of the chest.

Similar articles

See all similar articles

Cited by 1 article

References

    1. Nardelli DT, Callister SM, Schell RF. Lyme arthritis: current concepts and a change in paradigm. Clin Vaccine Immunol. 2008;15:21–34. doi: 10.1128/CVI.00330-07. - DOI - PMC - PubMed
    1. Byrnes V, Chopra S, Koziel MJ. Resolution of chronic hepatitis C following parasitosis. World J Gastroenterol. 2007;13:4268–4269. - PMC - PubMed
    1. Waton J, Pinault AL, Truchetet F. Lyme disease could mimic dermatomyositis. Rev Med Interne. 2007;28:343–345. doi: 10.1016/j.revmed.2007.01.002. - DOI - PubMed
    1. Horowitz HW, Sanghera K, Goldberg N. Dermatomyositis associated with lyme disease: case report and review of lyme myositis. Clin Infect Dis. 1994;18:166–171. - PubMed
    1. Arniaud D, Mattei JP, Pham T. Coexistent dermatomyositis relapsing polychondritis and positive Lyme serology. Rev Rhum Ed. 1997;64:589–590. - PubMed

LinkOut - more resources

Feedback