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The page below is a sample from the LabCE course Tickborne Diseases. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Case Study 1
A 12-year-old female from Santa Cruz, California presented with a swollen, painful right knee and hip. She reported recurrent knee swelling and pain lasting several days every four to five months. Her parents chose to treat her with herbs instead of antimicrobials when she was first seen with knee pain.
On this occasion, her WBC count was 7,000/mL, hematocrit was 33%, and the erythrocyte sedimentation rate (ESR) was 73 mm/h. A knee aspirate was taken and tests revealed 59,000 WBCs/mL and a protein of 5 g/dL. No growth was seen on the bacterial cultures, but the fluid was positive by PCR for the pathogen.
What do you suspect the pathogen to be?

Please select the single best answer