Children with knee monoarthritis from Lyme disease and septic arthritis can have similar presentations. The early disseminated stage of Lyme disease, when knee monoarthritis would typically present, occurs 3-5 weeks post tick bite and a history of tick bite may not be present. In addition, synovial fluid cell counts do not distinguish between septic and Lyme arthritis and bacterial cultures and Lyme disease serology may take several days to result.
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