Gonarthritis in the course of Lyme disease in a one-and-a-half-year-old child

A case of a one-and-a-half-year-old girl is reported in whom gonarthritis in the course of Lyme disease was diagnosed. The girl was brought up in an urban environment. She never was in a forest and had no contact with animals (except for a healthy pet-dog, which was under veterinary supervision). She did not attend a nursery, and went for walks only within urban area under the careful guidance of her parents. In spite of the negative family history the level of antibodies against Borrelia burgdorferi was estimated. A very high level of IgG antibodies and a low level of IgM Borrelia burgdorferi antibodies, accompanied by physical symptoms allowed to diagnose the second stage of Lyme disease. We considered the described case as worth presentation due to the child's very early age. Moreover, the infection was caused supposedly due to the contact with a dog (which may be unusual carrier of ticks), and not--as in most cases--in a forest.