*Intestinal Pseudoobstruction Caused by Chronic Lyme Neuroborreliosis

Intestinal Pseudoobstruction Caused by Chronic Lyme 
Neuroborreliosis. A Case Report

David F Schefte and Tyge Nordentoft
/Journal of / /Neurogastroenterology and Motility/, 2015; 
21(3): 440-442.

http://dx.doi.org/10.5056/jnm14118

Abstract

Chronic intestinal pseudoobstruction is often classified as 
idiopathic. The condition is associated with poor quality of 
life and high morbidity, and treatment options are often 
unsatisfactory.

A case of chronic intestinal pseudoobstruction in a 
66-year-old woman, presenting with back and abdominal pain, 
urinary retention and severe constipation is described. The 
patient lived in an area in which Lyme disease is endemic 
and had been bitten by ixodes ticks. Intrathecal synthesis 
of anti-borrelia IgM and IgG and lymphocytosis in the 
cerebrospinal fluid was found, consistent with chronic Lyme 
neuroborreliosis since symptoms had lasted for more than six 
months.

The patient's gastrointestinal function recovered and the 
pain subsided significantly following treatment with 
antibiotics. Lyme neuroborreliosis (LNB) often results in 
palsy, but rarely affects the autonomic nervous system. 
Three patients have been described with intestinal 
pseudoobstruction due to acute LNB.

However, this is the first described case of intestinal 
pseudoobstruction due to chronic Lyme neuroborreliosis. LNB 
must be suspected in patients with intestinal 
pseudoobstruction, in particular in patients who have been 
bitten by an ixodes tick and in patients living in an 
endemic area.

http://dx.doi.org/10.5056/jnm14118