Lyme meningitis, the major cause of childhood meningitis in an endemic area: A population based study
– Source: Archives of Disease in Childhood, Jan 13, 2012
By D Tveitness, et al.
[Note: Meningitis is a medical emergency disease caused by inflammation of the protective membranes covering the brain and spinal cord (meninges). It is usually caused by infection from viruses, bacteria, fungi or other microorganisms. Though this study in an area where Lyme is endemic shows more than two-thirds of cases were Lyme meningitis, most meningitis information does not list Lyme as a potential cause.]
Objective: To evaluate the epidemiology of infectious meningitis in children in a Lyme borreliosis (LB) endemic area, and to study how clinical and laboratory characteristics may distinguish between different types of childhood meningitis.
Design: Retrospective, population based study.
Setting: A pediatric department serving all children (62,000) in a costal LB endemic region of southwestern Norway.
Patients: All children with cerebrospinal fluid pleocytosis aged 3 months to 14 years.
Main outcome measures: Epidemiological, clinical and laboratory characteristics of different types of childhood meningitis.
Infectious meningitis was diagnosed in 211 children (annual incidence 38/100,000).
• Lyme meningitis (LM) was identified in 142 children (67%),
• Non-Lyme aseptic meningitis in 46 children (22%)
• And bacterial meningitis in 23 children (11%).
Age, month of admission and clinical and laboratory characteristics differed between the groups.
An etiological agent was found in 89% of children.
The positive predictive value for having LM if the child had facial nerve palsy or head and/or neck stiffness (meningism) as the only symptom was 97% for both variables.
Symptoms of cerebral involvement or signs of systemic inflammation were rare in children with LM compared to children non-Lyme aseptic meningitis.
LM was diagnosed in two-thirds of children with infectious meningitis in this LB endemic area.
Distinct clinical characteristics distinguished the majority of children with LM from children with non-Lyme aseptic meningitis and bacterial meningitis.
Source: Archives of Disease in Childhood, Jan 13, 2012. PMID:22247243, by Tveitnes D, Natås OB, Skadberg O, Oymar K. Department of Paediatrics, Stavanger University Hospital, Stavanger, Norway. [Email firstname.lastname@example.org]