Diagnostic Dilemma in a Case of Lyme Borreliosis Presenting as Severe Anion Gap Metabolic Acidosis: A Case Report

10 June 2023 : Case report USA

Unusual clinical course, Challenging differential diagnosis, Rare coexistence of disease or pathology

Lindsey A. Wallace^1ABDEF*, Sarah Cullison^1AE, Jacob Bowdon^1BCDEF, Aditya Shah^2DE, Sumera Ahmad^3ADEF

DOI: 10.12659/AJCR.939196

Am J Case Rep 2023; 24:e939196

Background Case Report Discussion Conclusions References:

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Table 3. Tickborne laboratory results.

	Patient’s result	Reference range
Lyme Ab IgM/IgG (blood)	Positive/positive	Negative/negative
Anaplasma phagocytophilum antibody IgG (blood)	1: 1024	<1: 64
Anaplasma phagocytophilum antibody IgG (blood)	1: 128	<1: 64
Lyme IgG (CSF)	Reactive	Non-reactive
Lyme CNS IgG Ab Index (CSF)	1.0	0.7–1.3
Ab – antibody; CSF – cerebrospinal fluid; CNS – central nervous system.

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