Excerpt:

Dermatomyositis has been described in the setting of lyme infection in
only nine previous case reports. Although lyme disease is known to
induce typical clinical findings that are observed in various collagen
vascular diseases, to our knowledge, we believe that our case is the
first presentation of acute lyme disease associated with amyopathic
dermatomyositis, which was then followed by severe and fatal
interstitial pulmonary fibrosis only two months later.