One Presentation, Two Continents: Left Wrist Myositis of Distinct Etiology in Genetically Similar Individuals

A 34-year-old man presented with a 5-day history of rapid onset weakness of the left wrist flexor muscles, associated with fever, sore throat, arthralgias, and myalgias. A literature review to answer the question, What could cause focal muscle weakness, fever, and myalgias? yielded several case reports describing initial presentations of polymyositis or unusual presentations of various infectious agents. Interestingly, the man in our case had a cousin in France, with whom he had no recent contact, who presented with the same symptoms approximately 3 months earlier. Because of our patient's recent travel history, testing was performed for Lyme disease, confirming our diagnosis. The man's cousin, however, had been similarly tested and was found negative for Lyme disease. (J Am Board Fam Med 2009;22:408-11.)