Abstract: [Borreliosis in children – clinical manifestation, diagnosis and treatment]

Med Wieku Rozwoj. 2003;VII(1):49-56.  [Article in Polish]  Duszczyk E, Karney A, Kowalewska-Kantecka B, Gryglicka H.  Klinika Chorob Zakaznych Wieku Dzieciecego, Akademia Medyczna, ul. Wolska 37, Warszawa, Poland.

Lyme Disease (Borreliosis) is a multisystem inflammatory disease caused by the spirochete Borrelia burgdorferi, transmitted by the bite of ixodes infected ticks. We would like to present our experience with the treatment of borreliosis in collaboration with the Warsaw Medical Academy's Department of Infectious Disease.

Fifty-nine children (aged between 14 months to 16 years) were hospitalized or ambulatorily treated due to borreliosis during 5 years between 1997 and 2001. Erythema migrans was observed in 50 cases. The main localisations of erythema were: face, neck and chest.

One patient showed erythema in several other localisations. Erythema migrans returned in two cases after therapy with Amoxicillin in one case at 6 months, in the other one 12 months later. The incubation period of erythema migrans in children varied from 4 to 30 days. Seven cases from the 59 occurred with central nervous system manifestations.

These were children between 6 and 16 years of age. The most frequent (65.5%) clinical manifestations of the central nervous system were meningitis and facial nerve palsy, depression and headaches were observed in 6% of cases. In one case admission to hospital was the result of leucopaenia (2800/mm3), bradycardia, headache and fatigue.

The positive serologic test results (Ellisa assay) were confirmed in two independent laboratories. We had one patient (5 years old boy) with arthritic manifestations. The diagnosis of Lyme disease was based on clinical manifestations and positive serologic test results (Ellisa assay). In the acute stage Ellisa assay was positive in 33% only. The erythema migrans cases received treatment with Amoxicillin for two weeks, whilst patients with neuroborreliosis were treated for 4 weeks with Ceftriaxon.

PMID: 13130169 [PubMed – as supplied by publisher]

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