Lyme arthritis versus acute bacterial arthritis: A diagnostic dilemma

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 9­year­old 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.