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conferenceseries
.com
Volume 5, Issue 3 (Suppl)
J Infect Dis Ther, an open access journal
ISSN:2332-0877
Infectious Diseases 2017
August 21-23, 2017
3
rd
Annual Congress on
Infectious Diseases
August 21-23, 2017 San Francisco, USA
Neuro sarcoidosis masquerading as neuroborreliosis (lymes)
Chandra Shekar Pingili
Sacred Heart and Saint Joseph Hospitals
Background:
Medical syndromes often overlap in clinical presentations. Often there is one or more than underlying etiology
responsible for the patient’s Clinical presentation. We are reporting a patient who was admitted thrice with fevers and joint
pains. Lymes IGG was positive. He was discharged home on doxycycline and prednisone suspecting gout. Second admission he
was discharged to home on IV ceftriaxone. Patient however was re admitted twice within 3 weeks with cognitive impairment.
Lymph node biopsy was positive for non caseating granulomas. Sarcoidosis was the final diagnosis.
Case Report:
74 year old white male was admitted with fever and multiple joint pains. Tmax was 100.5. WBC was 15 with
normal CBC. LFTs were elevated. Rest of the labs was normal. Lymes IGG was positive. He underwent extensive rheumatologic
and virological evaluation. Sonogram of the abdomen was negative. He responded to IV Ceftriaxone and was discharged
home on Doxycycline for 3 weeks and Prednisone taper for a week .He was readmitted within 2 weeks with weakness and
confusion. After ruling out multiple etiologies he was discharged home on IV Ceftriaxone suspecting Neuroborreliosis. But he
was re admitted with worsening mentation in a week. This time he was diagnosed as case of neurosarcoidosis. He responded
dramatically to IV steroids, methotrexate and one dose of infliximab. Patient continues to follow up with the clinic and is now
at his base line with no recurrence.
Conclusion:
He is one patient where an underlying disabling pathology was missed twice. He is a case of systemic and
neurosarcoidosis masquerading as neuroborreliosis. Rarely is a clinical encounter so perplexing.
Biography
Chandra Shekar Pingili is a Director, Division of infectious diseases, Sacred Heart and Saint Joseph Hospitals. Associate Professor of Medicine, University of
Wisconsin Madison at Eau Claire, Wisconsin. Actively involved in teaching family medicine residency program and nursing staff. Director of Infectious Diseases at
LE Phillips Rehab Center, Eau Claire and Chippewa Falls. Chief Infectious Disease adviser to the Clearwater Care Center, Eau Claire, WI. Chief Infectious Disease
adviser to the Dove Health and Rehab Center, Chippewa Falls, WI. Director of Infectious Diseases at Indian Head Medical Center.
hospitalist10@gmail.comChandra Shekar Pingili, J Infect Dis Ther 2017, 5:3 (Suppl)
DOI: 10.4172/2332-0877-C1-026