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Lyme Disease and Severe Hyperbilirubinemia: A Rare Presentation of Lyme Disease.
Cureus. 2020 May 30; 12(5):e8363.C

Abstract

A 39-year-old-man presented to the emergency room with a complaint of febrile jaundice and diffuse arthralgia. The patient had a temperature of 100°F, severe jaundice, and scleral icterus. Laboratory workup showed severe hyperbilirubinemia and elevated serum creatinine, and the rest of the serum chemistry was unremarkable. The ultrasound and computed tomography (CT) of the abdomen was normal. The patient had a recent history of travel to an endemic area for Lyme disease. After an extensive workup, all other possible etiologies had been ruled out, and the patient was started on empirical doxycycline by considering the patient's recent history of travel. Serum serologic test confirmed Lyme disease. His bilirubin and creatinine improved gradually. His fever subsided in three days, and he was discharged with outpatient follow-up. Although hyperbilirubinemia is rare in Lyme disease, it should be considered as a differential diagnosis in patients with severe jaundice and a recent history of travel.

Authors+Show Affiliations

Internal Medicine, King Edward Medical University, Mayo Hospital, Lahore, PAK.Internal Medicine, Pakistan Kidney and Liver Research Institute, Lahore, PAK.Internal Medicine, Fatima Jinnah Medical University, Sir Ganga Ram Hospital, Lahore, PAK.Infectious Disease, Wayne State University, Detroit, USA.Internal Medicine, Saint James School of Medicine, Chicago, USA.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32617234

Citation

Ahmed, Zahoor, et al. "Lyme Disease and Severe Hyperbilirubinemia: a Rare Presentation of Lyme Disease." Cureus, vol. 12, no. 5, 2020, pp. e8363.
Ahmed Z, Ur Rehman A, Awais A, et al. Lyme Disease and Severe Hyperbilirubinemia: A Rare Presentation of Lyme Disease. Cureus. 2020;12(5):e8363.
Ahmed, Z., Ur Rehman, A., Awais, A., Hanan, A., & Ahmad, S. (2020). Lyme Disease and Severe Hyperbilirubinemia: A Rare Presentation of Lyme Disease. Cureus, 12(5), e8363. https://doi.org/10.7759/cureus.8363
Ahmed Z, et al. Lyme Disease and Severe Hyperbilirubinemia: a Rare Presentation of Lyme Disease. Cureus. 2020 May 30;12(5):e8363. PubMed PMID: 32617234.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lyme Disease and Severe Hyperbilirubinemia: A Rare Presentation of Lyme Disease. AU - Ahmed,Zahoor, AU - Ur Rehman,Asad, AU - Awais,Anum, AU - Hanan,Abdul, AU - Ahmad,Sarfaraz, Y1 - 2020/05/30/ PY - 2020/7/4/entrez PY - 2020/7/4/pubmed PY - 2020/7/4/medline KW - doxycycline KW - hyperbilirubinemia KW - lyme disease SP - e8363 EP - e8363 JF - Cureus JO - Cureus VL - 12 IS - 5 N2 - A 39-year-old-man presented to the emergency room with a complaint of febrile jaundice and diffuse arthralgia. The patient had a temperature of 100°F, severe jaundice, and scleral icterus. Laboratory workup showed severe hyperbilirubinemia and elevated serum creatinine, and the rest of the serum chemistry was unremarkable. The ultrasound and computed tomography (CT) of the abdomen was normal. The patient had a recent history of travel to an endemic area for Lyme disease. After an extensive workup, all other possible etiologies had been ruled out, and the patient was started on empirical doxycycline by considering the patient's recent history of travel. Serum serologic test confirmed Lyme disease. His bilirubin and creatinine improved gradually. His fever subsided in three days, and he was discharged with outpatient follow-up. Although hyperbilirubinemia is rare in Lyme disease, it should be considered as a differential diagnosis in patients with severe jaundice and a recent history of travel. SN - 2168-8184 UR - https://www.unboundmedicine.com/medline/citation/32617234/Lyme_Disease_and_Severe_Hyperbilirubinemia:_A_Rare_Presentation_of_Lyme_Disease DB - PRIME DP - Unbound Medicine ER -
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