Salt, Ticks, and Lyme: A Case of Lyme Neuroborreliosis Presenting as SIADH

OCT 25, 2018 | NIHAAL KARNIK, MD; JAMES ROSSI, MD; ROHAN PARIKH, MD; AND RAVINDRA SANGITHA, MD
HISTORY OF PRESENT ILLNESS

A 79-year-old man with a medical history of coronary artery disease and hypertension presented to the emergency department (ED) with acute onset of ataxia and double vision in June 2018. Two days prior to his admission, he was seen at an outside ED for complaints of a headache. At the outside facility, he was found to have a blood pressure of 210/105 mm Hg, which was reduced with oral antihypertensives. Imaging at that hospital did not demonstrate any acute hemorrhage, and he was discharged with instructions to follow up with his primary care provider.

On the morning of the current admission, he awoke feeling ataxic and weak and had diplopia. He attempted to ambulate and subsequently fell while getting out of bed. He denied syncope or any post­ictal symptoms during this episode. The history was obtained from his daughter, who was at his bedside. The patient was unable to give a history secondary to his condition.

MEDICAL HISTORY

Coronary artery disease, with a known drug-eluting stent placed in 2009; hypertension; hyperlipidemia; and gout.

More at this link: https://www.contagionlive.com/publications/contagion/2018/october/salt-ticks-and-lyme-case-of-lyme-neuroborreliosis-presenting-as-siadh

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Many Blessings,

CrystalRiver