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It Started With A Tick: How One Bite Led To A Surprising Psychotic Episode

When Kevin Berean didn't feel like himself late in the summer of 2017, he knew it was more than just seasonal blues.

“I was feeling a great deal of anxiety, and yet I was in a completely detached state,” he said. “It’s hard to describe. I felt like I was on Earth, yet in a totally different world. I just didn’t feel like myself.” Berean cannot precisely recall the duration of his symptoms, but “it was probably several months."

Frightened by his altered state, Berean went to the Emergency Department of MidHudson Regional Hospital, a member of the Westchester Medical Center Health Network (WMCHealth), in September.

“Kevin presented with acute psychosis and hallucinations, but he had no history of mental illness,” said Dr. Daniela Stokes, an infectious disease specialist. “It is unusual to present with psychosis for the first time in your 30s.”

Berean refused treatment and left, only to return to the Emergency Department a few days later. He was immediately seen by a psychiatrist and deemed unable to make his own health decisions. “At the onset, there was a lot of confusion,” said Berean.

Sensing other factors were involved, Stokes ordered a full battery of tests. Berean underwent a full medical examination, and “his results came back strongly positive for Lyme Disease,” said Stokes. Berean underwent a spinal tap, the only way to confirm if the infection had crossed the blood-brain barrier – which it had.

“This comprehensive approach essentially represents state-of-the-art care," said Stokes. "At MidHudson Regional Hospital, when there is a new-onset psychosis evaluation, we conduct a complete medical workup to rule out medical illnesses that present as delirium, which can be indistinguishable from psychosis." 

Read more about Berean's diagnosis and treatment via Advancing Care in the Hudson Valley.

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