Abstract Details

Title Sacral Radiculitis as the First Manifestation of Lyme Neuroborreliosis

Topic Infectious Disease

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 13-002

Objective NA

Background Lyme disease, transmitted by the Ixodes species of ticks, is commonly seen in the northern hemisphere. However, radiculitis related to Lyme neuroborreliosis is an uncommon neurological complication of Lyme disease, characterized by inflammation of nerve roots. This clinical presentation can vary, and symptoms may not always follow typical dermatomal patterns. Lyme radiculitis in the sacral dermatomal distribution is extremely rare, and only a few cases have been previously reported.

Design/Methods A 30-year-old female with a history of asthma presented with a two-week history of progressive numbness involving the perianal region, labia, and lower buttocks. Patient experienced severe urinary retention prompting evaluation in the Emergency Department. On neurologic examination, there was decreased pain sensation in the vulva and perianal region. MRI lumbar spine revealed enhancement of the conus medullaris and sacral nerve roots. Subsequently, the patient underwent a lumbar puncture. Cerebrospinal fluid analysis showed lymphocytic pleocytosis, consistent with an inflammatory process. Serological testing confirmed a positive diagnosis of Lyme disease. The patient received a four-week course of ceftriaxone, resulting in complete resolution of her symptoms during a follow-up at five weeks.

Results NA

Conclusions

Sacral radiculitis is an atypical manifestation of Lyme neuroborreliosis. In our case, it was the first presentation of Lyme disease. Lyme should be considered in patients presenting with sacral radiculitis, particularly in endemic areas. Prompt recognition is vital, as early treatment can prevent long-term nerve damage and complications. Further research is warranted to better understand the pathophysiology of Lyme radiculitis and its varied presentations.

Authors/Disclosures
Aiman Sajjad, DO (LVHN) PRESENTER	Dr. Sajjad has nothing to disclose.
Brian Sacks, DO	Dr. Sacks has nothing to disclose.
Sayyeda Zahra, MD (Lehigh Valley Health Network)	Dr. Zahra has nothing to disclose.
Satinderpal Singh, DO (LVHN Division of Neurology)	Dr. Singh has nothing to disclose.
Alison L. Walsh, MD (Lehigh Valley Health Network)	Dr. Walsh has nothing to disclose.

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