A 4-year-old boy with ataxia and aphasia

Abstract

A n otherwise healthy 4-year-old boy was brought to hospital in late December after 3 days of nasal congestion and 2 days of fever, vomiting, malaise, ataxia and aphasia. The patient had a medical history of clubfoot. He had not yet received his immunizations (4-6 yr) or the seasonal influenza vaccine. On arrival, his vital signs were normal, but he had truncal and gait ataxia. The remainder of his neurologic and physical examination was normal. There was no nuchal rigidity, no ankle clonus and the Babinski sign was negative.

Lyme carditis and neuroborreliosis

“…The 3 cases presented in the Practice sec tion of the May 25, 2020, issue of CMAJ provide an informative discussion of the diagnosis and treatment of Lyme carditis and neuroborreliosis in a tertiary care centre. [1][2][3] I am a retired Ontario pediatri cian and coroner, having practised for more than 50 years. In the last 15 years I was a member of the Paediatric Death Review Committee of the Ontario Office of the Chief Corner.…”