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Background  Among a variety of more common differential diagnoses, the aetiology of acute respiratory failure includes Lyme neuroborreliosis.    Case presentation  We report an 87-years old huntsman with unilateral phrenic nerve palsy as a consequence of Lyme neuroborreliosis.    Conclusion  Although Lyme neuroborreliosis is a rare cause of diaphragmatic weakness, it should be considered in the differential workup because of its potentially treatable nature.

Unilateral phrenic nerve lesion in Lyme neuroborreliosis