Nina's Clinic

Ethan is 10 years old and loves the outdoors. Two weeks ago, his family went camping in Connecticut's woods for a long weekend. They hiked, fished, and slept in tents. Best trip ever, Ethan says. But now something is wrong. His mom brought him in because for the last four days, he's been exhausted (falling asleep by 6 PM), has a constant headache especially behind his eyes, and his knees and shoulders feel stiff and achy. He has a low fever that comes and goes. And this morning, his mom noticed something alarming on the back of his left thigh: a large, unusual rash. You ask Ethan to show you. On the back of his left thigh is a round, reddish rash about 15 centimeters across—roughly the size of a grapefruit. The outer edge is bright red. The middle has faded to nearly normal skin color. The area between is pinkish-red. It looks exactly like a bullseye on a target. Ethan says it doesn't itch or hurt. He has no idea how long it's been there—"it's on the back of my leg, I never look there."