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Báo cáo y học: " Oedema of the metatarsal heads II-IV and forefoot pain as an unusual manifestation of Lyme disease: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Oedema of the metatarsal heads II-IV and forefoot pain as an unusual manifestation of Lyme disease: a case report. | Journal of Medical Case Reports BioMed Central Case report Open Access Oedema of the metatarsal heads II-IV and forefoot pain as an unusual manifestation of Lyme disease a case report Stefan Endres 1 and Markus Quante2 Address Department of orthopaedic surgery Elisabeth-Klinik GmbH Bigge Olsberg Heinrich-Sommer-Str. 4 59939 Olsberg Germany and 2Department of orthopaedic surgery University of Marburg Baldingerstrasse 35039 Marburg Germany Email Stefan Endres - s.endres@elisabeth-klinik.de Markus Quante - quante@med.uni-marburg.de Corresponding author Published 9 July 2007 Received 10 March 2007 Journal of Medical Case Reports 2007 1 44 doi 10.1186 1752-1947-1-44 Accepted 9 July 2007 This article is available from http www.jmedicalcaserep0rts.c0m c0ntent 1 1 44 2007 Endres and Quante licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License http creativecommons.Org licenses by 2.0 which permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited. Abstract We report the case of a healthy 36 year old man who suffered from foot pain lasting for weeks without having a specific medical history relating to it. The clinical evaluation was interpreted as a transfer metatarsalgia caused by a splayfoot. The radiographs revealed no pathology except the splayfoot deformity. Due to persistent pain and swelling of the entire forefoot after two weeks of conventional treatment magnet resonance images MRI and a blood sample were taken. The laboratory investigation showed raised levels of white blood cell count and C-reactive protein. The MRI showed up oedema in the metatarsal heads II-IV as well as soft tissue swelling of the forefoot without any signs of decomposition. Because of this atypical inflammation of the forefoot a laboratory investigation to check for rheumatology disease was done and revealed borrelia burgdorferi infection. On the basis of these