Orbital inflammatory disease as a presenting feature of suspected Lyme neuroborreliosis: case report.

Orbital inflammatory disease (OID) is an inflammatory condition of the orbital and periorbital region. This case reports suspected Lyme neuroborreliosis underlying an initial presentation of OID in a 37-year-old male. Myositis was confirmed by computed tomography (CT) imaging. Cranial neuritis of the third, fifth, and seventh cranial nerves was evidenced by magnetic resonance imaging (MRI). Serology was positive for Borrelia burgdorferi IgM, but did not seroconvert to positive IgG. Thus, the rare diagnosis of orbital myositis as a presenting feature of suspected Lyme neuroborreliosis was established.