Systemic Sarcoidosis Associated with Exposure to Borrelia burgdorferi in a 21-Year-Old Man

OBJECTIVE: Here we describe a rare case of systemic sarcoidosis in a healthy young man with neuroborreliosis as a putative trigger. CASE: A 21-year-old forestry worker was diagnosed with systemic sarcoidosis involving his lungs, kidneys and skin. Additional diagnostics revealed signs indicative of a recent infection with Borrelia burgdorferi. The patient was treated successfully with prednisolone and antibiotics. CONCLUSION: Sarcoidosis is a multisystem granulomatous disorder of unknown aetiology. This case suggests that an infection with B. burgdorferi, the causal agent of Lyme disease, could act as a trigger for sarcoidosis. LEARNING POINT: We should maintain a high index of suspicion for underlying infectious processes like neuroborreliosis in patients with new-onset sarcoidosis before starting immunosuppressive regimens.