Fig. 1

a Multiple EM lesions as an unexpected finding on admission. The patient in this case presented with a chief complaint of chest palpitations, but EM lesions were noted as an incidental finding at the time of initial physical exam upon hospital admission, involving the leg (left panel), and shoulder (right panel). Lyme ELISA and IgM western blot confirmed the diagnosis of Borrelia burgdorferi infection. b First degree AVB in pediatric Lyme carditis. The patient was noted to have first degree AVB upon initial evaluation (left panel). PR interval after hospitalization, 396 msec (right panel). PR interval remained prolonged for the first 10 days of IV antibiotics, and transient episodes of second and third degree AVB were noted, but after day 10 the patient was in a sustained sinus rhythm with normal PR interval and was transitioned to oral antibiotics