Lyme disease pores and skin rash puzzles medical doctors, results in misdiagnoses

Lyme disease may cause an atypical pores and skin rash which may be mistakenly attributed to a different sickness, as this case report demonstrates. Of their article, Suzuki and colleagues describe a 43-year-old girl who developed a rash which puzzled medical doctors and led to a number of misdiagnoses earlier than Lyme disease was accurately recognized.

Lyme disease may cause an atypical pores and skin rash, which can be missed by clinicians. In this case report, a 43-year-old woman, who was an avid gardener and lived in Wisconsin, developed pink papules behind her proper knee.¹  Over the following a number of days, the rash “advanced into painless vesicles with surrounding faint erythema.” She additionally developed fever, chills, neck ache and malaise.

Diagnoses: shingles, cellulitis, necrotizing fasciitis

Medical doctors initially suspected shingles (Herpes Zoster) however remedy with valacyclovir, an antiviral treatment, didn’t enhance the pores and skin rash or signs. “The blisters elevated in dimension and confirmed purple discoloration,” the authors wrote.

The medical doctors then identified her with cellulitis, a bacterial pores and skin an infection which additionally causes a pores and skin rash. She was prescribed ceftriaxone, adopted by cephalexin and trimethoprim-sulfamethoxazole. However the girl remained ailing.

She was then referred for analysis for suspected necrotizing fasciitis, an irritation of the vessel partitions.  At the moment, she had a fever of 101.3°F.

“The atypical look of pores and skin rash would possibly confuse physicians with many differential diagnoses, corresponding to spider chunk, herpes zoster, bullous cellulitis, necrotizing fasciitis, and so forth.”

Moreover, “Bodily examination confirmed blister and a surrounding spherical erythematous patch on the proper popliteal fossa and proper inguinal lymphadenopathy,” the authors wrote.

Lyme disease pores and skin rash

The girl was identified clinically with “early Lyme disease with bullous erythema migrans.”

“Given the season, geographic location, out of doors exercise, and development regardless of remedy for cellulitis and shingles, she was clinically identified with early Lyme disease,” the authors report.

The girl was handled for Lyme disease with a 10-day course of doxycycline and her pores and skin rash resolved.

Laboratory exams for Lyme disease had been unfavourable – a standard incidence with early Lyme disease.

“The atypical look of pores and skin rash would possibly confuse physicians with many differential diagnoses, corresponding to spider chunk, herpes zoster, bullous cellulitis, necrotizing fasciitis, and so forth,” the authors level out.

Editor’s feedback:  I’ve seen rashes described on this article in my Lyme disease sufferers. I’m involved when a affected person is identified with shingles, cellulitis or necrotizing vasculitis earlier than Lyme disease is taken into account as a attainable explanation for an atypical pores and skin rash.

If unsure in regards to the root explanation for the rash, I’ll sometimes deal with sufferers with a mixture of medicines together with an antiviral agent and an antibiotic that’s efficient in treating cellulitis, a spider chunk and Lyme disease.