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Letters |15 April 1994

Atrial Myxoma Mimicking Lyme Disease

Francesco Drago, MD; Guido Nazzari, MD; Franco Crovato, MD

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Author, Article, and Disclosure Information
  • Chiarvari Hospital; Chiavari, Gensa; Italy
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TO THE EDITOR:
We report an unusual case in which misinterpretation of clinical or serologic findings led to overdiagnosis and overtreatment of Lyme borreliosis.
In October 1992, a 46-year-old man developed multiple, slowly enlarging annular erythematous lesions on his legs. These were accompanied by fatigue, headache, low-grade fever, myalgias, and arthralgias. Because of a history of insect bites, an enzyme-linked immunosorbent assay (ELISA) for Lyme antibody was done. The test result was negative, and no laboratory test abnormalities were found. In December, he was admitted to a neurology department because of paresis of his right median nerve; cutaneous lesions and systemic symptoms persisted unchanged. Laboratory findings were normal again except for the presence of positive IgM antibody to Borrelia burgdorferi at low titer. The diagnosis of Lyme disease was suggested, and treatment with ceftriaxone (2 g/d for 15 days) was begun. Paresis and skin lesions resolved within a few days, but the patient's general condition did not significantly improve.
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Drago F, Nazzari G, Crovato F. Atrial Myxoma Mimicking Lyme Disease. Ann Intern Med. 1994;120:696. doi: 10.7326/0003-4819-120-8-199404150-00025

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Published: Ann Intern Med. 1994;120(8):696.

DOI: 10.7326/0003-4819-120-8-199404150-00025

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