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Lyme arthritis versus acute bacterial arthritis: A diagnostic dilemma
Dinushan Kaluarachchi1, Magda Mendez2, Shefali Khanna3
1Pediatric Resident, Department of Pediatrics, Lincoln Medical and Mental Health Center, Bronx, NY.
2Program Director, Pediatric Residency Program, Lincoln Medical and Mental Health Center Assistant Professor of Clinical Pediatrics, Weill Cornell Medical College.
3Director, Pediatric Department, Lincoln Medical and Mental Health Center Assistant Professor of Clinical Pediatrics, Weill Cornell Medical College.

doi:10.5348/ijcri-2012-12-240-CR-14

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How to cite this article:
Kaluarachchi D, Mendez M, Khanna S. Lyme arthritis versus acute bacterial arthritis: A diagnostic dilemma. International Journal of Case Reports and Images 2012;3(12):62–64.


Abstract
Introduction: Lyme disease is a known cause of monoarticular arthritis in Lyme endemic areas. It must be differentiated from other types of acute monoarticular arthritis such as acute bacterial arthritis.
Case Report: In this report, we discuss the case of a 9-year-old boy who presented to emergency room with left wrist monoarthritis of one day's duration. Initial laboratory evidence were suggestive of septic arthiritis and treatment was initiated for the presumed diagnosis of septic arthritis, but high index of suspicion lead to further investigations and diagnosis of Lyme arthritis.
Conclusion: Diagnosis of Lyme arthritis may be difficult. Exposure in an endemic area and clinical findings may help distinguish it from acute bacterial arthritis.

Keywords: Lyme arthritis, Acute bacterial arthritis, Borrelia burgdoferi


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Author Contributions
Dinushan Kaluarachchi – Substantial contributions to analysis and interpretation of data, Clinical patient care, Drafting the article, Final approval of the version to be published
Magda Mendez – Substantial contributions to analysis and interpretation of data, Clinical patient care, Drafting the article, Final approval of the version to be published
Shefali Khanna – Substantial contributions to analysis and interpretation of data, Clinical patient care, Drafting the article, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© Dinushan Kaluarachchi et al. 2012; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.)