Radicular Back and Abdominal Pain with Ileus, Rash, and SIADH in Lyme Neuroborreliosis

Lyme disease is the most common tick-borne disease in the United States. Lyme neuroborreliosis occurs when systemic infection leads to neurologic involvement. Neuroborreliosis presents with a wide spectrum of clinical manifestations but classically presents with facial nerve palsy. Here, we present a case with a rare constellation of symptoms including radicular back and abdominal pain, ileus, rash, and SIADH due to Lyme disease with suspected neuroborreliosis. This case highlights the importance of recognizing atypical presentations of Lyme disease, especially for patients in Lyme endemic areas.