Abdominal Radicular Pain From Neuroborreliosis: A Case of Bannwarth Syndrome in the Midwestern United States

A man in his mid-50s from Illinois presented with a circular rash without central clearing on his thigh. Two weeks later, he developed radicular lower abdominal and back pain. While initial imaging of the abdomen and lumbar spine was unrevealing, a physical examination later uncovered the subtle fin...

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Main Authors: Abigail E. Schulz, Justin Kearney, Nitin Das Kunnathu Puthanveedu, Manasa Kandula
Format: Article
Language:English
Published: American College of Physicians 2025-02-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2024.0798
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author Abigail E. Schulz
Justin Kearney
Nitin Das Kunnathu Puthanveedu
Manasa Kandula
author_facet Abigail E. Schulz
Justin Kearney
Nitin Das Kunnathu Puthanveedu
Manasa Kandula
author_sort Abigail E. Schulz
collection DOAJ
description A man in his mid-50s from Illinois presented with a circular rash without central clearing on his thigh. Two weeks later, he developed radicular lower abdominal and back pain. While initial imaging of the abdomen and lumbar spine was unrevealing, a physical examination later uncovered the subtle finding of dermatomal hypoesthesia. After a positive 2-tier test for Lyme disease, a diagnosis of Bannwarth syndrome was confirmed by cerebrospinal fluid, revealing lymphocytic pleocytosis and an elevated Lyme antibody index. Despite its historical association with the European Borrelia species, in the United States, Bannwarth syndrome should be considered in patients with radicular pain.
format Article
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issn 2767-7664
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publishDate 2025-02-01
publisher American College of Physicians
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series Annals of Internal Medicine: Clinical Cases
spelling doaj-art-3ce8e052b3764eca9577fbf58cf3d6de2025-08-20T03:18:45ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642025-02-014210.7326/aimcc.2024.0798Abdominal Radicular Pain From Neuroborreliosis: A Case of Bannwarth Syndrome in the Midwestern United StatesAbigail E. Schulz0Justin Kearney1Nitin Das Kunnathu Puthanveedu2Manasa Kandula31University of Illinois College of Medicine at Peoria, Peoria, Illinois1University of Illinois College of Medicine at Peoria, Peoria, Illinois1University of Illinois College of Medicine at Peoria, Peoria, Illinois1University of Illinois College of Medicine at Peoria, Peoria, IllinoisA man in his mid-50s from Illinois presented with a circular rash without central clearing on his thigh. Two weeks later, he developed radicular lower abdominal and back pain. While initial imaging of the abdomen and lumbar spine was unrevealing, a physical examination later uncovered the subtle finding of dermatomal hypoesthesia. After a positive 2-tier test for Lyme disease, a diagnosis of Bannwarth syndrome was confirmed by cerebrospinal fluid, revealing lymphocytic pleocytosis and an elevated Lyme antibody index. Despite its historical association with the European Borrelia species, in the United States, Bannwarth syndrome should be considered in patients with radicular pain.https://www.acpjournals.org/doi/10.7326/aimcc.2024.0798
spellingShingle Abigail E. Schulz
Justin Kearney
Nitin Das Kunnathu Puthanveedu
Manasa Kandula
Abdominal Radicular Pain From Neuroborreliosis: A Case of Bannwarth Syndrome in the Midwestern United States
Annals of Internal Medicine: Clinical Cases
title Abdominal Radicular Pain From Neuroborreliosis: A Case of Bannwarth Syndrome in the Midwestern United States
title_full Abdominal Radicular Pain From Neuroborreliosis: A Case of Bannwarth Syndrome in the Midwestern United States
title_fullStr Abdominal Radicular Pain From Neuroborreliosis: A Case of Bannwarth Syndrome in the Midwestern United States
title_full_unstemmed Abdominal Radicular Pain From Neuroborreliosis: A Case of Bannwarth Syndrome in the Midwestern United States
title_short Abdominal Radicular Pain From Neuroborreliosis: A Case of Bannwarth Syndrome in the Midwestern United States
title_sort abdominal radicular pain from neuroborreliosis a case of bannwarth syndrome in the midwestern united states
url https://www.acpjournals.org/doi/10.7326/aimcc.2024.0798
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