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To the Editor.—
During the summer of 1975, we saw two children in Hyannis with severe myalgia and expanding annular lesions that fit the description of the erythema chronicum migrans. Both these patients, aged 9 and 11 years, had difficulty walking because of the myalgia associated with their illness. Because of their contact with saltwater swimming around fish piers, the diagnosis of erysipeloid (fish-handlers disease) was entertained. Subsequently, we learned that after the children returned home (one to Newington, Conn, and one to Winchester, Mass) transient arthritis developed in both.In retrospect, these two children may well have had the new form of arthritis recently described in Lyme, Conn. Our experience was the reverse of the Connecticut group; we saw the rash and not the subsequent arthritis.
Hazard GW, Leland K, Mathewson HO. Erythema Chronicum Migrans and "Lyme Arthritis". JAMA. 1976;236(21):2392. doi:10.1001/jama.1976.03270220014012
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