ABSTRACT
We report a 10-year-old girl who presented with acute arthritis of the left knee, which was confirmed as Lyme arthritis by serology and molecular assay. Careful history and examination were the keys to suspecting the diagnosis. The patient lived in the US for five years and her symptoms developed about a year after her return to Oman. To the best of our knowledge, this is the first case report of Lyme arthritis in Oman and the Arabian Gulf region. This case indicates the need to suspect Lyme disease in patients presenting with compatible symptoms and a history of recent travel to endemic regions.
ABSTRACT
Unilateral proptosis is a rare initial presenting sign of acute myeloid leukemia (AML). We report a case of unilateral proptosis in a six-year-old girl as the initial manifestation of AML. The cancer link was initially missed and the case was investigated as one of hyperthyroidism. Peripheral blood smear and bone marrow aspirate evaluation showed signs diagnostic of AML. Computed tomography scan of orbits showed infiltrative process in the right orbit, right maxillary, and right ethmoidal sinuses. Unilateral proptosis as an extramedullary first presenting feature of AML is very rare; however, it should always be considered in the differential diagnosis of proptosis in pediatric age group.
