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An eight-year-old girl presented with acute cerebellar syndrome and meningitis. Lumbar puncture showed elevated pressure. Examination of the cerebrospinal fluid showed lymphocytosis, raised protein and decreased glucose. She was initially treated with acyclovir and antituberculosis drugs with partial response. Subsequently, the antibody assay for Borrelia burgdorferi was positive and the antimicrobial regime was changed to ceftriaxone. She made a full recovery with no neurological deficit. A probable diagnosis of
Lyme disease was made and the diagnostic approach to
Lyme disease is discussed.