Unusual presentation of lyme disease: Horner syndrome with negative serology

Candis Morrison, Ari Seifter, John N. Aucott

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Early disseminated Lyme disease can be difficult to diagnose because of atypical symptoms and physical findings. A clinical diagnosis must be made in the absence of confirmatory serologic testing to allow timely therapy. We report a case of a 69-year-old woman who presents with fever, Horner syndrome, and a 12-cm oval-shaped erythematous macular rash with multiple vesiculopustular eruptions. The patient recovered after appropriate intravenous antibiotics, but serologic testing only confirmed the diagnosis 4 weeks later. This case also describes an unusual complication involving the neurologic system. We illustrate the clinical presentation and review the medical literature. Lyme disease should always be considered in patients from endemic regions with viral-like symptoms or a new rash.

Original languageEnglish (US)
Pages (from-to)219-222
Number of pages4
JournalJournal of the American Board of Family Medicine
Issue number2
StatePublished - Mar 2009

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Family Practice


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