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Case Reports
. 2024 Aug 12;16(8):e66713.
doi: 10.7759/cureus.66713. eCollection 2024 Aug.

Prime Time or Lyme Time: A Case of Lyme Hepatitis in the Emergency Department

Megan E Weis  1 , Danny Le  1 , Timothy J Friel  2 , Michelle N Carraro  1
Affiliations
Case Reports

Prime Time or Lyme Time: A Case of Lyme Hepatitis in the Emergency Department

Megan E Weis et al. Cureus. .

Abstract

Lyme disease, a tick-borne illness, is caused by the spirochete Borrelia burgdorferi. Lyme disease commonly presents with the characteristic erythema migrans rash, fever, malaise, headache, and arthralgias. Some patients may have mild liver manifestations, including abnormal liver function tests (LFTs), hyperbilirubinemia, or granulomatous hepatitis. Significant LFT abnormalities and hepatitis in a case of Lyme disease are rare. Here, we present a case of Lyme hepatitis in the emergency department (ED) where the patient presented with classic Lyme symptoms and was also found to have markedly elevated aspartate transaminase (AST) and alanine transaminase (ALT), mild alkaline phosphatase (ALP) elevation, and mild hyperbilirubinemia.

Keywords: abnormal liver studies; emergency management; erythema migrans; lyme disease; transaminitis.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Erythema migrans rashes on the patient’s right side identified by arrows
Figure 2
Figure 2. Bulls-eye rashes on the patient’s back identified by arrows
See this image and copyright information in PMC

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