Orbital myositis with Lyme disease.

We examined, treated, and followed up for nine years a 5-year-old girl with active Lyme disease and orbital myositis. Clinically, the patient demonstrated typical symptoms for each of the major stages of Lyme disease, including fever, erythema chronicum migrans, aseptic meningitis, Bell's palsy, and arthritis. She subsequently developed clinical and computed tomographic evidence of orbital myositis. Although orbital myositis is generally considered to be an idiopathic inflammation, our findings suggest that in certain patients it may be a manifestation of Lyme disease.