P45 Lyme-associated uveitis: Panuveitis and positive Lyme results – is it a masquerade or the real deal?

Abstract Introduction/Background A 5 year old boy presented with unilateral panuveitis and on screening tests was lineblot positive for Lyme IgM in the setting of other screening results being negative. He was treated for active Lyme disease with antibiotics and the uveitis treated with steroids. To date, good responses … but is this a Lyme-associated uveitis, or a red herring result which will evolve into more than simple monophasic disease? The differential of Juvenile Idiopathic Arthritis related uveitis remains a concern, ensuring adequate treatment and monitoring in place for disease evolution is crucial. Description/Method 5 year old boy referred to Ophthalmology with an absent red reflex, anterior chamber cells, no hypopyon, but no clear fundal views in the left eye. The differential diagnosis was autoinflammatory/infective and possibly Juvenile Idiopathic Arthritis. On subsequent review he had iris vascularisation with anterior vitritis. He started maxidex and atropine drops. On review by paediatric rheumatology he was noted to have one painless lump on the top of his left foot, no other rashes and no arthritis. An isolated small posterior right cervical chain node