10 June 2023>: Articles
Diagnostic Dilemma in a Case of Lyme Borreliosis Presenting as Severe Anion Gap Metabolic Acidosis: A Case Report
Unusual clinical course, Challenging differential diagnosis, Rare coexistence of disease or pathology
Lindsey A. Wallace A* , Sarah Cullison A , Jacob Bowdon B , Aditya Shah D , Sumera Ahmad ADOI: 10.12659/AJCR.939196
Am J Case Rep 2023; 24:e939196
Table 2. Cerebrospinal fluid analysis from lumbar puncture.
Patient’s result | Reference value/range | |
---|---|---|
Color | Clear | Clear |
Protein | 68 | 0–35 |
Glucose | 93 mg/dL | (60% of plasma glucose) |
Total nucleated cells | 2/mcL | 0–5/mcL |
Erythrocytes | 1/mcL | 0/mcL |
Neutrophils | 75% | 2±4% |
Lymphocytes | 22% | 60±20% |
Monocytes/macrophages | 3% | 30±15% |
Eosinophils, basophils, other cells | 0% | 0% |
Blasts | 0 | 0 |
Encephalitis panel* | Negative | Negative |
Ehrlichia chaffeensis antibody IgG | Negative | Negative |
Ehrlichia muris eauclairensis | Negative | Negative |
Babesia microti, duncani, divergens PCR | Negative | Negative |
Babesia microti IgG Ab | ||
Powassan virus IgM ELISA | Negative | Negative |
HIV 1/2-antigen and antibody screen | Negative | Negative |
Syphilis IgG with reflex EIA | Negative | Negative |
RPR screen with reflex to titer | Negative | Negative |
Urine test for West Nile | Negative | Negative |
* Encephalitis panel tested for the following: K1, , , , , , cytomegalovirus, enterovirus, herpes simplex 1 & 2, human herpesvirus 6, human parechovirus, varicella zoster virus, and . EIA – enzyme immunoassay; HIV – human immunodeficiency virus; RPR – rapid plasma reagin. |