An Interesting Presentation of Lyme Pseudothrombophlebitis

Area of Science:

• Pediatric Infectious Diseases
• Musculoskeletal Infections
• Rheumatology

Background:

• Lyme disease, a tick-borne illness, can manifest with diverse symptoms.
• Pseudothrombophlebitis is a rare complication, mimicking deep vein thrombosis.
• Early diagnosis and appropriate management are crucial for favorable outcomes.

Observation:

• An 8-year-old boy presented with left knee and calf swelling, pain, erythema, and warmth.
• Imaging revealed a large, heterogeneous collection in the gastrocnemius muscle with surrounding myositis.
• Initial presentation mimicked deep vein thrombosis.

Findings:

• Surgical drainage and irrigation of the affected calf collection were performed.
• Lyme serology testing of aspirated fluid confirmed Lyme disease.
• The patient was diagnosed with Lyme pseudothrombophlebitis.

Implications:

• This case underscores the importance of considering Lyme disease in pediatric patients with pseudothrombophlebitis.
• Prompt diagnosis and treatment, including antibiotics and surgical intervention if necessary, are vital.
• Recognizing atypical presentations of Lyme disease can prevent diagnostic delays and improve patient management.