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Rigshospitalet - a part of Copenhagen University Hospital
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Lyme Neuroborreliosis in a Patient with Breast Cancer: MRI and PET/CT Findings

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  1. Preoperative Embolization of a Solitary Fibrous Tumor Originating from External Auditory Meatus: A Case Report with Literature Review

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  2. Limited diagnostic utility of Chromogranin A measurements in workup of neuroendocrine tumors

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  3. Gastrointestinal Applications of Iodine Quantification Using Dual-Energy CT: A Systematic Review

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  4. Renal 123I-MIBG Uptake before and after Live-Donor Kidney Transplantation

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  1. CT and MR neuroimaging findings in patients with Lyme neuroborreliosis: A national prospective cohort study

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  2. Severe acute hepatitis E infection presenting with acute abdomen and meningoencephalitis

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We present a case demonstrating the performance of different radiographical and nuclear medicine imaging modalities in the diagnostic work-up of a patient with Lyme neuroborreliosis. The patient presented in late summer 2019 with radicular pains followed by a foot drop and peripheral facial palsy, both right-sided. Due to a history of breast cancer, disseminated malignant disease was initially suspected. Bone metastasis was ruled out by skeletal scintigraphy. Magnetic resonance imaging (MRI) of the neuroaxis and a whole body 18F-FDG PET-CT was performed within 48 hours. The MRI revealed a strong contrast enhancement of the conus medullaris and fibers of the cauda equina, while the 18F-FDG PET/CT was without pathological findings. Examination of cerebrospinal fluid led to the definitive diagnosis of Lyme neuroborreliosis with monocytic pleocytosis and a positive intrathecal test for Borrelia burgdorferi. The patient became pain-free after 10 days of ceftriaxone, and the paralysis slowly regressed the following month. This case highlights the difficulty of the diagnosis of Lyme neuroborreliosis and discusses the relevant imaging findings.

Original languageEnglish
JournalDiagnostics
Volume10
Issue number1
ISSN2075-4418
DOIs
Publication statusPublished - 9 Jan 2020

ID: 59422283