# Severe Acute Respiratory Distress Syndrome in Lyme Disease: A Case Report and Review of the Literature

## TL;DR

A 70-year-old woman developed ARDS and was later diagnosed with Lyme disease, showing it can cause this rare complication.

## Contribution

This is a rare case report linking Lyme disease to ARDS, expanding its known complications.

## Key findings

- Lyme disease can present as ARDS even without typical risk factors like outdoor exposure.
- The patient recovered after treatment with antibiotics and ICU care.
- This case emphasizes the need to consider rare causes when diagnosing ARDS.

## Abstract

While there are many etiologies of acute respiratory distress syndrome (ARDS), Lyme disease is not a known cause of this disorder, and there is a paucity of Lyme-associated ARDS cases reported in the medical literature. In this report, we present a case of a 70-year-old woman with ARDS requiring mechanical ventilation, who initially had recurrent negative infectious workups but was ultimately diagnosed with Lyme disease with positive Lyme serology and western blot. The patient, who is from the New York City metropolitan area, had no outdoor exposure, recent travel history, or sick contacts. She experienced a complicated intensive care unit (ICU) course, including septic shock requiring antibiotics, vasopressors, and multiple diagnostic tests. Ultimately, the patient recovered and was transferred to the medicine unit and subsequently discharged in stable condition. This case highlights a rare complication of Lyme disease and highlights the importance of considering rare etiologies in the differential diagnosis of ARDS with an unclear etiology.