Damage to the nerve roots of the brachial plexus in the course of Lyme disease in a 15-year-old girl

Lyme disease is a multi-organ infectious disease and the most common vector-borne disease in Europe and North America. An infection is caused by the spirochetes Borrelia burgdorferi, B. afzelii, and B. garinii, affecting all age groups, especially in temperate climates. We report a case of a 15-year-old female patient, who was hospitalised due to right upper limb paresis accompanied by a noticeable decline in both muscle strength and exteroceptive sensation. Extensive laboratory and imaging assessments were conducted to rule out injury complications, as well as vascular and neurological disorders of the head and cervical spine. Despite the absence of a history of tick bite or erythema migrans, Borrelia-specific IgM and IgG antibodies were detected in the patient’s blood serum. Although initial cerebrospinal fluid analysis showed no antibodies, subsequent testing confirmed the presence of Borrelia antibodies, confirming the neuroborreliosis. The patient received a combination of antibiotic therapy, steroid therapy, and physiotherapy due to her clinical condition. Electroneurography revealed nerve damage in the weakened upper limb. Given the escalating incidence of borreliosis cases, particularly in paediatric populations, this case underscores the importance of heightened vigilance among specialists for such atypical presentations like radiculopathy, emphasising the need for timely diagnosis and intervention.