Lyme disease misdiagnosed as shingles in a 62-year-old man

A recent article, published in the journal Clinical Case Reports, describes the case of a 62-year-old man, from Norway, who was initially diagnosed with shingles, a viral infection which produces a painful skin rash with blisters in a localized area on the body. [1] Shingles, also known as herpes zoster, is common in older individuals who have had chickenpox.


According to Hansen and colleagues, the man was admitted to the emergency department complaining of epigastric pain that had been ongoing for 4 to 5 weeks. “He described a constant pain with episodic worsening,” writes Hansen. The pain began with a rash in the man’s right upper quadrant area.

Physicians considered several diagnoses. The man had a history of migraines, anxiety, colon polyps and had been treated for gastroesophageal reflux disease (GERD). Small gallbladder stones were present but were not acute.

The man was diagnosed with shingles and prescribed acyclovir and pregabalin. Despite treatment, he remained ill. His pain increased and “he developed additional symptoms including nausea, lethargy, decreased appetite, constipation, decreased size and force of the urinary stream, and a 5–7 kg weight loss,” writes Hansen.

It wasn't shingles, it was Lyme disease. Click To Tweet

Imaging and lab tests were negative and the man was discharged. However, one week later, he was re-admitted to the hospital because “his general practitioner did not find it reasonable that his anxiety could explain his current symptoms,” says Hansen.

The man lived in an area endemic for Lyme disease. Although he did not recall a recent tick bite, he had been bitten previously, so serologic tests for Lyme disease were performed. Because his titers of B. burgdorferi IgG were so high and he had a history of tick bites and a rash, a lumbar puncture was ordered. Results were positive.

The 62-year-old man was diagnosed with Lyme neuroborreliosis. His symptoms, except for fatigue, resolved after a 3-week course of IV ceftriaxone. “His weight is now normalized and he has no problems with constipation,” explains Hansen. “The abdominal pain is almost gone. His main problem is fatigue but this is gradually improving.”

The authors point out that atypical clinical presentations of Lyme neuroborreliosis can occur, including gastrointestinal manifestations because of autonomous dysfunction, as was seen in this case.


Related Articles:

What happens to the brain during acute Lyme neuroborreliosis?

At least 50% of patients with Lyme neuroborreliosis remain ill years after treatment

When it looks like a brain tumor, but it is Lyme disease


  1. Hansen BA, Finjord T, Bruserud O. Autonomous dysfunction in Lyme neuroborreliosis. A case report. Clin Case Rep. 2018;6(5):901-903.


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Dr. Daniel CameronLinda SpennatoSusieCatrina HodgesJoyce Cacchione Recent comment authors
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I was diagnosed with Lymes in 2013. Initially my Dr. thought it was contact dermatitis and or costrocondritis. My symptoms were skin pain no joint pain. My skin hurt from the waist up, lost weight and fatigue before I asked my Dr to check me for Lymes. I recently went to see a neurologist and was diaganoised with postherpetic neuralgia. Had shingles in November and reoccurred without rash in January. just the burning sensation on my skin lasting along time. I’m a 68 yr old female.I feel my immune system has been tampered from the lymes so I am refusing… Read more »

Linda Spennato
Linda Spennato

I was diagnosed with Lyme in 2012. By 2015 I was much improved. Then, I had hip problems followed by back pain. A steroid injection helped with the hip. A few months later, I received an epidural for my low back. Days after,I had a shingles outbreak at the injection site. It was not diagnosed as shingles until 2 1/2 yrs later. I had multiple treatments, surgeries, etc… They all failed. I haven’t been able to sit or stand in place for 3 yrs now. In Dec 2018, I had a huge breakout which spread across my upper butt and… Read more »

Catrina Hodges

I have had ongoing problems with my eye for 13 years. I was also diagnosed with shingles, and took 1mg of Acyclovir for years, but never got better. After many years of being misdiagnosed, undiagnosed, or accused of being delusional, I flew to VA, and was diagnosed with Chronic Lyme disease , a RMSF coinfection, and Morgellons disease. I am 47 years old, married with two children. The last 13 years of my life have (literally) been hell on earth! Because I live in GA, it is costly, and therefore causes a great financial hardship for me to fly to… Read more »

Cathrine Mihm
Cathrine Mihm

Yes me too but did not resolve with ceftriaxone IV….using pure stevia leaf extract and homeopathic nosode tincture. ..getting well

Joyce Cacchione
Joyce Cacchione

Hi Cathrine. Glad to see you had success with a more holistic treatment plan. Would you be willing to share a little more info about your lyme disease story. I’ve been sick for many years and rely solely on natural treatments. I am currently pulsing two sets of remedies every two weeks, both sets containing one remedy that attacks the parasites and a second remedy that breaks through the biofilm. I do whatever I can to detox including sweating, epsom salt baths and glutathione. I’m thinking of mixing things up a bit to rid my body of this horrific disease… Read more »