One hundred patients, aged 6-15 years and presented to El-Shatby University Children’s Hospital with chronic/recurrent arthritis and skin lesions suggestive of erythema chronicum migrans (ECM), were investigated for presence of IgG antibodies against Borrelia burgdorferi flagellum antigen ELISA test. Four cases yielded positive serum samples which were true positive cases as they showed negative Venereal
Disease Research Laboratory (VDRL) test. Ticks collected from domestic animals from the houses of serologically positive patients were found belonging to hard tick: Rhipicephalus sanguineus. Based on clinical ground, only one case was strongly suspected to have
Lyme disease due to the presence of the distinctive skin lesion (ECM) while the other three cases were not diagnosed till the results of serological test. This study provides serological evidence concerning the presence of
Lyme disease in Egypt. Further efforts of identify its prevalence, various clinical presentations, vectors and animal hosts are warranted.