Lyme meningitis, the major cause of childhood meningitis in an endemic area: a population based study

Tveitnes, Dag; Natås, Olav B.; Skadberg, Øyvind; Øymar, Knut

doi:10.1136/archdischild-2011-300526

Cited by 29 publications

(27 citation statements)

References 38 publications

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“…In adults, ACA has an estimated prevalence of 1-2% among all LB patients with skin manifestations and preferentially affects elderly people in Europe (11). We found that SEM affects boys and girls equally as the most typical skin manifestation of early LB with a median incubation period and disease duration of one week, which is comparable with prior literature (11)(12)(13)(14)(15)(16) days) (20,21,36). The majority of SEM in our children (79%) and in previous European studies (46-58%) (20,21) occurred at the site of a recalled tick bite.…”

Section: Discussionsupporting

confidence: 90%

“…For example, ACA typically affects elderly adults, whereas BL is primarily diagnosed in children (11,14). Peripheral facial nerve palsy and aseptic meningitis are the most common neurologic manifestation of LB in children (3,9,10,16,17), whereas adults are commonly affected by radiculoneuritis (5). Data suggest that Lyme arthritis is more frequent in children than in adults (3,18), but runs a more favorable course as 10% of adults but very few children develop chronic Lyme arthritis (3,19).…”

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confidence: 99%

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Clinical Spectrum of Skin Manifestations of Lyme Borreliosis in 204 Children in Austria

Glatz¹,

Resinger²,

Semmelweis³

et al. 2015

Acta Derm Venerol

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The spectrum of skin manifestations of Lyme borreliosis in children is not well characterized. We conducted a retrospective study to analyze the clinical characteristics, seroreactivity to Borrelia burgdorferi sensu lato, and outcome after treatment in 204 children with skin manifestations of Lyme borreliosis seen in 1996-2011. Solitary erythema migrans was the most common manifestation (44.6%), followed by erythema migrans with multiple lesions (27%), borrelial lymphocytoma (21.6%), and acrodermatitis chronica atrophicans (0.9%). A collision lesion of a primary borrelial lymphocytoma and a surrounding secondary erythema migrans was diagnosed in 5.9% of children. Rate of seroreactivity to B. burgdorferi s.l. was lower in solitary erythema migrans compared to other diagnosis groups. Amoxicillin or phenoxymethylpenicillin led to complete resolution of erythema migrans within a median of 6 (solitary) and 14 days (multiple lesions), respectively, and of borrelia lymphocytoma within a median of 56 days. In conclusion, erythema migrans with multiple lesions and borrelial lymphocytoma appear to be more frequent in children than in adults, whereas acrodermatitis chronica atrophicans is a rarity in childhood. The outcome after antibiotic therapy was excellent in children, and appears to be better than in adults.

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Section: Discussionsupporting

confidence: 90%

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confidence: 99%

Clinical Spectrum of Skin Manifestations of Lyme Borreliosis in 204 Children in Austria

Glatz¹,

Resinger²,

Semmelweis³

et al. 2015

Acta Derm Venerol

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“…The inclusion criteria for the various diagnostic groups were defined prior to the start of the study, and the children were subsequently allocated to the groups based on laboratory findings upon admission, as shown in Table 1 and as described in more detail elsewhere (23). Children with probable LNB were considered likely to have LNB because LNB is the predominant cause of aseptic meningitis in children in this region (24), and it has been shown previously that this group has a clinical presentation similar to that of children with confirmed LNB in this area (9). In this study of PCR for B. burgdorferi sensu lato, all diagnostic groups listed in Table 1 were included, except for the nonmeningitis group, because the inclusion criteria for this group were wide, and we expected that this group would include a large number of children with an unclear likelihood of having LB and a low pretest probability of having positive PCR results.…”

Section: Methodsmentioning

confidence: 99%

Direct Molecular Detection and Genotyping of Borrelia burgdorferi Sensu Lato in Cerebrospinal Fluid of Children with Lyme Neuroborreliosis

et al. 2018

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The current diagnostic marker of Lyme neuroborreliosis (LNB), the antibody index (AI) in the cerebrospinal fluid (CSF), has insufficient sensitivity in the early phase of LNB. We aimed to elucidate the diagnostic value of PCR for in CSF from children with symptoms suggestive of LNB and to explore genotypes associated with LNB in children. Children were prospectively included in predefined groups with a high or low likelihood of LNB based on diagnostic guidelines (LNB symptoms, CSF pleocytosis, and antibodies) or the detection of other causative agents. CSF samples were analyzed by two -specific real-time PCR assays and, if DNA was detected, were further analyzed by five singleplex real-time PCR assays for genotype determination. For children diagnosed as LNB patients (58 confirmed and 18 probable) ( = 76) or non-LNB controls ( = 28), the sensitivity and specificity of PCR for in CSF were 46% and 100%, respectively. DNA was detected in 26/58 (45%) children with AI-positive LNB and in 7/12 (58%) children with AI-negative LNB and symptoms of short duration. Among 36 children with detectable DNA, genotyping indicated ( = 27) and non- ( = 1) genotypes, while 8 samples remained untyped. Children with LNB caused by did not have a distinct clinical picture. The rate of detection of DNA in the CSF of children with LNB was higher than that reported previously. PCR for could be a useful supplemental diagnostic tool in unconfirmed LNB cases with symptoms of short duration. was the predominant genotype in children with LNB.

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“…Incidence of NB among children in some European countries, where this disease is endemic, is higher than among adults (3) and it is the main cause of meningitis (4). Sex-dependent differences in the incidence of NB among children were reported.…”

Section: Introductionmentioning

confidence: 97%

Neuroborreliosis – clinical presentation – Current state of knowledge

Krawczuk¹,

Czupryna

Pancewicz

et al. 2019

Przegl Epidemiol

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Neuroborreliosis is one of the manifestations of Lyme disease involving central and peripheral nervous system. It is caused by infection with Borrelia burgdorferi spirochete which is transmitted by tick bites. Neuroborreliosis can affect both adults and children. The clinical course in children is often different than in adults. The article discusses the most common clinical symptoms, complications, diagnostics and treatment of neuroborreliosis in children.

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Lyme meningitis, the major cause of childhood meningitis in an endemic area: a population based study

Abstract: 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.

Cited by 29 publications

References 38 publications

Clinical Spectrum of Skin Manifestations of Lyme Borreliosis in 204 Children in Austria

Clinical Spectrum of Skin Manifestations of Lyme Borreliosis in 204 Children in Austria

Direct Molecular Detection and Genotyping of Borrelia burgdorferi Sensu Lato in Cerebrospinal Fluid of Children with Lyme Neuroborreliosis

Neuroborreliosis – clinical presentation – Current state of knowledge

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