Update Aug 2015!
Lyme neuroborreliosis: a treatable cause of acute ocular motor disturbances in children.
Correll MH1, Datta N2, Arvidsson HS3, Melsom HA3, Thielberg AK4, Bjerager M4, Brodsky MC5, Saunte JP1
Br J Ophthalmol. 2015 Apr 13. pii: bjophthalmol-2015-306855. doi: 10.1136/bjophthalmol-2015-306855.
- 1Department of Ophthalmology, Nordsjællands Hospital Hillerød, Hillerød, Denmark Department of Ophthalmology, Copenhagen University Hospital Glostrup, Glostrup, Denmark.
- 2Department of Ophthalmology, Copenhagen University Hospital Glostrup, Glostrup, Denmark.
- 3Department of Ophthalmology, Nordsjællands Hospital Hillerød, Hillerød, Denmark.
- 4Department of Pediatrics, Nordsjællands Hospital Hillerød, Hillerød, Denmark.
- 5Departments of Ophthalmology and Neurology, Mayo Clinic, Rochester, Minnesota, USA.METHODS:
Six paediatric patients (age 3-15 years) with ocular motor symptoms as first manifestations of LNB evaluated by a paediatrician and ophthalmologist are presented. Diagnosis was based on new onset ocular motor disturbances and detection of cerebrospinal fluid (CSF) pleocytosis and intrathecal synthesis of Bb IgM and/or IgG antibodies by lumbar puncture. The children were evaluated before and after antibiotic treatment with a follow-up time of 1-7 months. Videos were obtained both pre and post treatment in four patients.
Two children presented with acquired nystagmus, one with combined nystagmus and partial sixth nerve palsy, one with partial sixth nerve palsy, one with ptosis and one with Adie’s pupil. Five of the patients presented with severe fatigue, malaise, nausea, headache and fever. Four had recognised a tick bite recently, and two developed erythema migrans. Intrathecal synthesis of IgM and/or IgG antibodies specific for Bb was positive in all children, and five showed CSF pleocytosis. Cerebral MRI or CT of the brain were normal. Treatment with intravenous or oral antibiotics produced rapid clinical improvement in five of the six children.
LNB can present as acute ocular motor disorders in conjunction with fatigue and other clinical manifestations. In endemic areas, children with unexplained, acquired ocular motor abnormalities should be evaluated for LNB, a treatable medical condition.
A Unique Case of Adolescent Neuroborreliosis Presenting With Multiple Cranial Neuritis and Cochlear Inflammation on Magnetic Resonance Imaging
Ewers, Evan C. et al. Pediatric Neurology , Volume 52 , Issue 1 , 107 – 109 Published Online: October 15, 2014
Lyme disease is the most common vector-borne disease in the United States and is caused by infection with the spirochete Borrelia burgdorferi. In children, neuroborreliosis usually presents as peripheral facial nerve palsy and lymphocytic meningitis and only rarely is associated with cranial polyneuritis.
We present a 15-year-old with tinnitus, hearing loss, and facial nerve palsy in the setting of acute, severe right arm pain and a several week history of malaise and headache. Lumbar puncture was notable for lymphocytic pleocytosis. Serologic testing demonstrated positive Lyme antibody and a positive immunoglobulin M Western blot. Immunofluorescent assay of cerebrospinal fluid was also positive for anti-Lyme immunoglobulin M. Audiologic testing revealed mixed, right-sided hearing loss. Neuroimaging demonstrated cranial polyneuritis and right-sided cochlear inflammation. The patient was treated with parenteral ceftriaxone with resolution of his symptoms at close follow-up.
Neuroborreliosis with radiculopathy, lymphocytic meningitis, and cranial polyneuritis is a rare presentation of pediatric Lyme disease. Additionally, cochlear inflammation along with cranial nerve VIII inflammation may contribute to hearing loss in patients with neuroborreliosis.
Full paper available at: http://www.pedneur.com/article/S0887-8994%2814%2900607-9/
Munchausen’s syndrome by proxy and Lyme disease: Medical misogyny or diagnostic mystery?
Virginia T. Sherr
Medical Hypothesis Elsevier press
Received 30 March 2005; accepted 4 April 2005
Full 8 page article available at:http://theoneclickgroup.co.uk/documents/ME-CFS_docs/MSBP-MEDICAL%20MISOGYNY.pdf (PDF)
Lyme Disease Presenting With Persistent Headache
Pediatrics Vol. 112 No. 6 December 1, 2003
We describe 2 case reports of children with neuroborreliosis who presented with chronic headache, cerebrospinal fluid (CSF) pleocytosis, and increased intracranial pressure. Neuroborreliosis with increased intracranial pressure can cause optic neuropathy and has caused permanent blindness in patients. The potential ophthalmologic complications make this an important diagnosis.
Full article available at: http://pediatrics.aappublications.org/content/112/6/e477.full
Research shows Bartonella can be transferred from mother to unborn child, possibly causing birth defects
06 MAY 2010
A North Carolina State University researcher has discovered that Bartonella (a common Lyme co-infection) can be passed to unborn babies, causing chronic infections and possibly birth defects. Breitschwerdt’s research group tested blood and tissue samples taken over a period of years from a mother, father and son who had suffered chronic illnesses for over a decade. Autopsy samples from their daughter–the son’s twin who died shortly after birth–contained DNA evidence of B. henselae and B. vinsonii subsp. berkhoffi infection, which was also found in the other members of the family.
More details at: https://www.lymedisease.org/423/
A message from Dr Horowitz on Congenital Lyme:
“I have had women who have had multiple miscarriages secondary to Lyme, where both the placenta and fetus showed evidence of infection. In this article in Scientific American.com, it discusses the risk of transmission of Lyme to the fetus. Other tick-borne infections, such as the relapsing fever spirochete, as well as Babesia and Bartonella can also be transmitted to the fetus. Tick-borne infections represent a significant risk to pregnant women, and although the article states that there is little scientific evidence to suggest fetal malformations, I have included a bibliography below to show that in fact there are many scientific articles proving that Lyme can both harm and kill a developing fetus.”
For links to article & bibliography hop to: http://whatislyme.com/a-message-from-dr-horowitz-on-congenital-lyme/
Baby boy in the UK suffers from Lyme disease seriously affecting his vision..
BADA posters for kids
– ages 4-11, 11-16 & 16+, plus make your own Tommy the Tick!
Update Apr 2015!
Adventures of Luna & Dips (tick) by Tick Talk Ireland is now available worldwide on kindle
Tips on prevention & tick identification chart also included (available on all amazon sites worldwide – non kindle readers can download an app for phone, laptop, PC..)
All proceeds go towards keeping our websites up & running!
_____________________________________________________________________________________________Update Aug 2014!
School Days – Illnesses to Watch Out for in Ireland
School Days – Prevent the Risk of Lyme disease this Summer
Long-Term Side Effects of Lyme Disease in Teens by Bonnie Weinstein Crowe
Lyme Disease: A Guide to Prevention (Middle School): DVD & Curriculum Material
School Psychology – Lyme Disease: Etiology, Neuropsychological Sequelae, and Educational Impact By R. A. Hamlen & D. S. Kliman
Treatment of TBD in Paediatric & Pregnant Patients by Ann Corson 2012
Resources Regarding Educating Children with Lyme Disease
With thanks to L’il Lymies..
Children and Lyme Disease
The ABC’s of Lyme Disease
Distinct Pattern of Cognitive Impairment Noted in Study of Lyme Patients
Lyme Disease and Cognitive Impairments
What Everyone Needs To Know About Pediatric Lyme Disease 5/26/08 Ann F Corson MD 1 (slide show presentation)
Educating Schools About Lyme and Tick Borne Diseases & Getting Your Child Help with Lyme-related Issues (Dr. Jones site)
Update Apr 2014!
Neurologic Manifestations of Lyme Disease in the Pediatric Population
Dorothy Pietrucha, MD, FAAP, of the Jersey Shore Medical Center, Neptune, New Jersey, discussed diagnostic and treatment issues in pediatric neurologic Lyme disease.
The Spectrum of Gastrointestinal Manifestations in Children and Adolescents With Lyme Disease.
Martin Fried, MD, Matthew Abel, MD, Dorothy Pietrucha, MD, Yen-Hong Kuo, MS, Aswine Bal, MD
Also by the same authors:
Borrelia burgdorferi Persists in the Gastrointestinal Tract of Children and Adolescents With Lyme Disease
KIDS AND LYME DISEASE – HOW IT AFFECTS THEIR LEARNING
Sandy Berenbaum, LCSW, BCD Family Connections Center for Counseling
Lyme Times Fall/Winter 2002/3
Children’s Lyme Network
Children’s Lyme Disease Network is an all-volunteer organization consisting of parents, caregivers and family members who have seen first-hand the struggles a child can face once infected with Lyme Disease.
We’re committed to promoting awareness and prevention of Lyme Disease. We focus on school-aged children, who are most at-risk of becoming infected.
Incs FAQS & Coping with Lyme Disease..
Update Mar 2014!
Chronic Lyme Disease in Kids
In an ambulatory care setting, the nurse often spends as much or more time with the child than the physician.
By Ginger Savely, MEd, MSN, RN, FNP-C
Posted on: October 24, 2005
Vol. 3 •Issue 22 • Page 25
Lyme disease, a tick-borne disease named for the town of Lyme, CT, where the first U.S. outbreak occurred, is present in every state and is more prevalent than most people realize. The so-called deer ticks that transmit the infection are so tiny that they frequently are not detected by unsuspecting victims.
Only about 40 percent of bites are followed by the tell-tale “bull’s eye” rash; consequently, the early, acute and easily treatable phase of the illness often is missed.1 Months to years later, children can present with a host of seemingly unrelated and puzzling symptoms that parents and doctors often do not associate with past exposure to ticks. Thus, the possibility of chronic disseminated Lyme disease is usually not entertained.2
In an ambulatory care setting, the nurse often spends as much or more time with the child than the physician. While taking vital signs and gathering preliminary information from the parent, the nurse is in a unique position to pick up on “red flags” for chronic disseminated Lyme disease. Since most doctors do not think to include this disease in their differential assessment,2 heightened awareness on the part of the nurse could make a significant difference in determining the correct diagnosis.
The nurse should put up her “Lyme radar” when a child is a frequent visitor to the office, has many and varied complaints, or has symptoms that have eluded diagnosis by other healthcare providers. More details in the following link..
Update Nov 2013!
Maternal Lyme borreliosis and pregnancy outcome.
Int J Infect Dis. 2010 Jun;14(6):e494-8. doi: 10.1016/j.ijid.2009.07.019. Epub 2009 Nov 18.
Lakos A, Solymosi N.
The Center for Tick-borne Diseases, Visegrádi 14, Budapest, H-1132, Hungary. firstname.lastname@example.org
There is disagreement regarding whether Lyme borreliosis is associated with adverse pregnancy outcome.
We performed a review of the data from 95 women with Lyme borreliosis during pregnancy, evaluated at the Center for Tick-borne Diseases, Budapest over the past 22 years.
Treatment was administered parenterally to 66 (69.5%) women and orally to 19 (20%). Infection remained untreated in 10 (10.5%) pregnancies. Adverse outcomes were seen in 8/66 (12.1%) parentally treated women, 6/19 (31.6%) orally treated women, and 6/10 (60%) untreated women. In comparison to patients treated with antibiotics, untreated women had a significantly higher risk of adverse pregnancy outcome (odds ratio (OR) 7.61, p=0.004). While mothers treated orally had an increased chance (OR 3.35) of having an adverse outcome compared to those treated parenterally, this difference was not statistically significant (p=0.052). Erythema migrans did not resolve by the end of the first antibiotic course in 17 patients. Adverse pregnancy outcome was more frequent among these ‘slow responder’ mothers (OR 2.69), but this was not statistically significant (p=0.1425) . Loss of the pregnancy (n=7) and cavernous hemangioma (n=4) were the most prevalent adverse outcomes in our series. The other complications were heterogeneous.
Update April 2013!
New Book out written by Jenny O’Dea
Great news – the new book ‘Adventures of Luna & Dips’ is now completed & available FREE to schools & members of the public (for Irish residents only!). Suitable for ages 8/9 & up, the book written by Tick Talk Ireland’s co-founder Jenny O’Dea aims to encourage people young and old to learn about ticks and the dangers of Lyme disease. Please note that supplies are limited and will be offered on a first come first served basis. Packs for schools will also include leaflets for the parents, a poster for the school, plus information for teacher including tips on prevention, colouring sheets, plus child friendly websites for more information.
Please note that all copies of Luna have now been snapped up by schools across Ireland but is now available for free download, more details as follows:
NB: the downloadable version is no longer available however Luna has been newly released on kindle at: http://www.amazon.co.uk/Adventures-Luna-Dips-Jenny-ODea-ebook/dp/B00VS46RIQ
Download accompanying poster
Updated 2nd Oct 2012
Rationale for treating long term by Dr Charles Ray Jones
Acute facial nerve palsy in children: how often is it lyme borreliosis?
Scand J Infect Dis. 2007;39(5):425-31
Authors: Tveitnes D, �ymar K, Nat�s O
Acute facial nerve palsy in children may be caused by infection by Borrelia burgdorferi, but the incidence of facial nerve palsy and the proportion of facial nerve palsy caused by Lyme borreliosis may vary considerably between areas. Furthermore, it is not well known how often facial nerve palsy caused by Lyme borreliosis is associated with meningitis. In this population-based study, children admitted for acute facial nerve palsy to Stavanger University Hospital during 9 y from 1996 to 2004 were investigated by a standard protocol including a lumbar puncture. A total of 115 children with facial nerve palsy were included, giving an annual incidence of 21 per 100,000 children. 75 (65%) of these were diagnosed as Lyme borreliosis, with all cases occurring from May to November. Lymphocytic meningitis was present in all but 1 of the children with facial nerve palsy caused by Lyme borreliosis where a lumbar puncture was performed (n = 73). In this endemic area
for Borrelia burgdorferi, acute facial nerve palsy in children was common. The majority of cases were caused by Lyme borreliosis, and nearly all of these were associated with lymphocytic meningitis.
PMID: 17464865 [PubMed – in process]
Lyme borreliosis–the most frequent cause of acute peripheral facial paralysis in childhood]
[Article in German]
Christen HJ, Bartlau N, Hanefeld F, Thomssen R.
Abteilung Kinderheilkunde, Schwerpunkt Neuropädiatrie, Universität Göttingen.
A prospective hospital-based multicentre study in Lower Saxony allowed to investigate the frequency of acute peripheral facial palsy due to Lyme borreliosis and its clinical and laboratory characteristics. Diagnosis of Lyme Borreliosis was based on detection of IgM antibodies against Borrelia burgdorferi in serum and CSF as well, using an IgM capture ELISA. Between June 1986 and October 1987 27 consecutive cases with acute peripheral facial palsy were studied. Lyme borreliosis is the main cause of peripheral facial palsy in childhood. It was verified serologically in two thirds of the cases. All cases with a positive history for a tick bite and/or an erythema migrans in the head-neck region showed ipsilateral neurological affection suggesting a direct invasion via the affected nerve by Borrelia burgdorferi. Peripheral facial palsy due to Lyme borreliosis represents a monosymptomatic meningoradiculitis. All children with Lyme borreliosis revealed a
lymphocytic CSF pleocytosis, whereas in cases of unknown etiology CSF findings usually were normal. Therefore, in any case of facial palsy with an inflammatory CSF syndrome Lyme borreliosis has to be suspected unless proven otherwise.
PMID: 2716745 [PubMed – indexed for MEDLINE]
Lyme neuroborreliosis in children.
Department of Pediatrics, University Hospital, Goettingen, Germany.
Children are more likely than adults to be bitten by ticks and thus more likely to be infected by Borrelia burgdorferi. In a serosurvey the infection rate measured by immunoglobulin G (IgG) antibodies was 2.6%. In a prospective hospital-based multicentre study 169 children with Lyme neuroborreliosis were examined; the infection was diagnosed by detection of specific immunoglobulin M (IgM) antibodies in the cerebrospinal fluid (CSF) using an IgM capture ELISA. The yearly incidence of Lyme neuroborreliosis was 5.8 cases per 100,000 children aged 1-13. Facial palsy and lymphocytic meningitis account for nearly 90% of all cases with neuroborreliosis indicating striking differences in the clinical spectrum between children and adults. Lyme borreliosis proves to be the most frequently verifiable cause of acute peripheral facial palsy in children, causing every second case of this disorder in the summer and autumn. In cases of facial palsy, nearly all patients
with a positive history of tick bite or erythema migrans in the head and neck region show ipsilateral subsequent facial nerve palsy, suggesting a direct invasion via the affected nerve by Borrelia burgdorferi. Lyme borreliosis is the third most frequent cause of lymphocytic meningitis in childhood. Inflammatory changes of the cerebrospinal fluid along with the presence of specific antibodies are mandatory for the diagnosis of Lyme neuroborreliosis. High-dose intravenous penicillin G as well as third-generation cephalosporins prove to be effective in paediatric Lyme neuroborreliosis.
PMID: 8811167 [PubMed – indexed for MEDLINE]
[Diagnosis and therapy of Lyme borreliosis in children. Practice guideline of the German Society for Pediatric Infectious Diseases]
Klin Padiatr. 1999 Mar-Apr;211(2):70-4.
Hobusch D, Christen HJ, Huppertz HI, Noack R.
Univ.-Kinder- und Jugendklinik, Rostock.
[Article in German]
Lyme borreliosis is the most frequent tickborne disease of man in the Northern hemisphere. A variety of systems may be involved. The most frequent manifestations in childhood include erythema migrans, meningitis, cranial nerve palsy and arthritis. Erythema migrans usually is easily recognised and determination of antibodies to Borrelia burgdorferi should not be performed. Childhood neuroborreliosis is characterised mostly by aseptic meningitis with or without cranial nerve palsy, in most cases facial palsy. Basic CSF findings often show a combined evidence of lymphocytic pleocytosis, IgM-class dominance in intrathecal humoral immune response, and blood-CSF barrier dysfunction. Calculation of the Borrelia burgdorferi specific antibody index (according to Reiber) proved to be the most sensitive method for detecting intrathecal synthesis of specific antibodies. Lyme arthritis presents initially as episodic oligoarthritis, mostly involving the knee joint, and may turn into chronic monoarthritis of the knee; usually high titers of IgG antibodies to Borrelia burgdorferi are found. The rarer manifestations encephalomyelitis, chronic arthritis, carditis and inflammatory eye disease may be difficult to diagnosis due to clinical ambiguity and problems in the interpretation of serological results. Antibodies to Borrelia burgdorferi found by sensitive Elisa must always be confirmed by immunoblot analysis, but sometimes immunoblot analysis is more sensitive than Elisa. Treatment is by antibiotics, amoxicillin or doxyciclin for erythema migrans, and i.v. third generation cephalosporins for all other manifestations. Even after successful antibiotic therapy, antibodies may persist for months and years and no further antibiotic treatment is necessary in the absence of attributable clinical manifestations. The differentiation between a persisting immune response and a persisting infection therefore has to be based upon the clinical symptoms, non-specific laboratory data and the development of the antibody titers.
PMID: 10407814 [PubMed – indexed for MEDLINE]
The Role of Neuropsychological Testing in Children with Lyme Disease
by Leo Shea, Ph.D. and Judith Leventhal, Ph.D.
SUMMARY: Provides a comprehensive review of neuropsych testing and its benefits for Lyme patients, particularly children.
A controlled study of cognitive deficits in children with chronic Lyme disease.
Tager FA, Fallon BA, Keilp J, Rissenberg M, Jones CR, Liebowitz MR.
Columbia University Department of Psychiatry, Division of Behavioral Medicine, New York, New York 10032, USA. email@example.com
Although neurologic Lyme disease is known to cause cognitive dysfunction in adults, little is known about its long-term sequelae in children. Twenty children with a history of new-onset cognitive complaints after Lyme disease were compared with 20 matched healthy control subjects. Each child was assessed with measures of cognition and psychopathology. Children with Lyme disease had significantly more cognitive and psychiatric disturbances. Cognitive deficits were still found after controlling for anxiety, depression, and fatigue. Lyme disease in children may be accompanied by long-term neuropsychiatric disturbances, resulting in psychosocial and academic impairments. Areas for further study are discussed.
PMID: 11748319 [PubMed – indexed for MEDLINE]
Lyme Games (for kids)
If you know of any young ones who might want to learn about Lyme this is excellent.
Put the Tick Parts Together:
Naming Body Parts of a Tick:
Finding the Garden Danger Zones:
Billy’s Maze (while avoiding the ticks!)
Find the Ticks (see how many you can spot in the bushes)
Dress Billy (before he goes into the country)
Memory Game (match 2 identical ticks from a pack)
Looks like fun!!
Fatal Progressive Encephalitis Following an untreated Deer Tick attachment on a 7 year-old Fairfield County, Connecticut child.
Liegner KB, Jones CR.
VIII International Conference on Lyme Borreliosis and other Emerging Tick-borne Diseases, June 25,1999
Due to the sad nature of this article the details have not been entered on this page. Please only click on this link at your own discretion.
Musculoskeletal manifestations of Lyme disease in children.
Cristofaro RL, Appel MH, Gelb RI, Williams CL.
Lyme disease, caused by a tick-transmitted spirochete, has significant musculoskeletal manifestations in children as well as in adults. A series of 23 children with Lyme disease is examined. Acute arthritis was present in five cases, with the knee being involved in three of these cases. Twelve cases (52%) presented with arthralgias, and 10 cases (43%) presented with myalgias. Neurological manifestations were present in 39% of the cases. Five cases have demonstrated recurrent polyarthralgias. Lyme disease should be considered in the differential diagnosis of arthralgias and arthritis in children.
PMID: 3624462 [PubMed – indexed for MEDLINE]
MRI findings in children infected by Borrelia burgdorferi.
Belman AL, Coyle PK, Roque C, Cantos E.
Department of Neurology, School of Medicine, State University of New York, Stony Brook 11794.
Cranial magnetic resonance imaging abnormalities were observed in 8 children (5 boys, 3 girls; ages 4-14 years) with neurologic problems following infection by Borrelia burgdorferi, the etiologic agent of Lyme disease. Neurologic features included headache (6), behavioral changes (5), facial palsy (2), papilledema (2), papilledema with diplopia (1), disturbance of sleep pattern (2), and carpal tunnel syndrome (1). Two MRI studies demonstrated multiple focal areas of increased signal intensity in white matter on long TR (both proton-density and T2-weighted) images.
PMID: 1476570 [PubMed – indexed for MEDLINE]
Don’t Let the Ticks Bite!
Kids may be more likely to encounter ticks and get tick-bites because they may go off trails, play in grassy areas or in leaves under trees in natural habitats where ticks are found. They may also be less likely to notice a tick if one attaches to them. The tick-bite prevention information on this page is designed for youth in the 4th – 6th grade and can be used in the classroom, scout groups, other youth groups, or at home.
P.S. check out the don’t let the ticks bite sideshow – very good!
Another great site for kids is:
Posters designed by the European Centre for Disease Control:
Acute pediatric monoarticular arthritis: distinguishing lyme arthritis from other etiologies.
Pediatrics. 2009 Mar;123(3):959-65.
Thompson A, Mannix R, Bachur R.
Children’s Hospital Boston, Division of Emergency Medicine, 300 Longwood Ave, Boston, MA 02115, USA. firstname.lastname@example.org
OBJECTIVE: Identify clinical predictors of Lyme arthritis among patients with acute monoarticular arthritis. METHODS: A medical chart review was conducted of children </=18 years of age with monoarticular arthritis who underwent arthrocentesis in a pediatric emergency department located in the northeast United States. Patients were classified into 3 categories of arthritis: septic, Lyme, or nonseptic non-Lyme arthritis. Historical, clinical, and laboratory data were compared to identify distinguishing features of Lyme arthritis.
RESULTS: One hundred seventy-nine patients were studied: 46 (26%) patients with septic arthritis, 55 (31%) patients with Lyme arthritis, and 78 (43%) patients with nonseptic non-Lyme arthritis. Compared with those with septic arthritis, patients with Lyme disease were more likely to have a tick-bite history, knee involvement, and less likely to have a history of fever or elevated temperature at triage. Erythrocyte sedimentation rate, C-reactive protein, joint white blood cell count, and joint neutrophil percentage were also statistically lower. In comparison to nonseptic non-Lyme arthritis, knee involvement and tick-bite history were predictors of Lyme. Erythrocyte sedimentation rate, joint white blood cell count, and joint neutrophil percentage were also statistically different. Multivariate analysis comparing Lyme to septic arthritis demonstrated fever history and elevated C-reactive protein level to be negative predictors of Lyme arthritis and knee involvement to be a positive predictor (model sensitivity: 88%; specificity: 82%).
CONCLUSIONS: Lyme arthritis shares features with both septic and nonseptic non-Lyme arthritis. This overlap prevents the creation of a clinically useful predictive model for Lyme arthritis. In endemic areas, Lyme testing should be performed on all patients presenting with acute monoarticular arthritis.
PMID: 19255026 [PubMed – indexed for MEDLINE]
Saving Our Children:
Evaluation and Management of Pediatric Tick-Borne Diseases (Dr Ann Corson)
A team of fundraisers to help support children with chronic Lyme disease
WHO WE ARE
First and foremost we are people that hate Lyme Disease!!
We raise awareness of lyme disease by wearing our bright Team Lyme shirts during races, runs, triathlons, to the grocery store, etc.
We are all ages, fitness levels and live in different states across the county. Lyme Disease TICKS US OFF!
TEAM LYME welcomes anyone that wants to support children struggling with chronic Lyme Disease!!
WHAT WE DO
TEAM LYME supports education, research and the fight against chronic Lyme Disease.
Team Lyme supports Lyme Disease organizations that have the same goal: to educate, prevent and fight chronic Lyme Disease.
TEAM LYME MEMBERSHIP
Start raising awareness with your Team Lyme tshirt!
Join Team Lyme with a one time entry fee of $25. Team Lyme membership includes:
TEAM LYME t-shirt
TEAM LYME magnet
Lyme Disease Support Pin
100% of proceeds go towards fighting lyme disease!
Lyme carditis in children: presentation, predictive factors, and clinical course.
Costello JM, Alexander ME, Greco KM, Perez-Atayde AR, Laussen PC.
Harvard Medical School, Division of Cardiac Intensive Care, Department of Cardiology, Children’s Hospital Boston, 300 Longwood Ave, Bader 600, Boston, MA 02115, USA. email@example.com
OBJECTIVES: We sought to identify predictive factors for Lyme carditis in children and to characterize the clinical course of these patients. METHODS: We reviewed all cases of early disseminated Lyme disease presenting to our institution from January 1994 through July 2008, and summarized the presentation and course of those patients with carditis. A case-control study was used to identify predictive factors for carditis. Controls were patients with early disseminated Lyme disease without carditis.
RESULTS: Of 207 children with early disseminated Lyme disease, 33 (16%) had carditis, 14 (42%) of whom had advanced heart block, including 9 (27%) with complete heart block. The median time to recovery of sinus rhythm in these 14 patients was 3 days (range: 1-7 days), and none required a permanent pacemaker. Four (12%) of 33 patients with carditis had depressed ventricular systolic function, 3 (9%) of whom required mechanical ventilation, temporary pacing, and inotropic support. Complete resolution of rhythm disturbances and myocardial dysfunction occurred in 24 (89%) of 27 patients for whom follow-up data were available. Most patients with carditis also had other systemic Lyme involvement. By using multivariate logistic regression analysis, we found that children >10 years of age, those with arthralgias, and those with cardiopulmonary symptoms were more likely to have carditis.
CONCLUSIONS: The spectrum of presentation for children with Lyme carditis is broad, ranging from asymptomatic, first-degree heart block to fulminant myocarditis. Variable degrees of heart block are the most common manifestation and occasionally require temporary pacing. Transient myocardial dysfunction, although less common, can be life-threatening. Advanced heart block resolves within 1 week in most cases. In children with early disseminated Lyme disease, older age, arthralgias, and cardiopulmonary symptoms independently predict the presence of carditis.
PMID: 19403477 [PubMed – indexed for MEDLINE]
Lyme arthritis in a 12-year-old patient after a latency period of 5 years.
Albert S, Schulze J, Riegel H, Brade V.
Institute Med. Microbiology, University Hosptial Frankfurt, Frankfurt/M., Germany.
Lyme arthritis (LA) may be confused with other rheumatic diseases, particularly in the absence of a history of erythema migrans (EM). We report the case of a 12-year-old patient who developed a large effusion of the right knee joint. The titer for antinuclear antibodies was 1:80 and the test for rheumatoid factor was negative. Investigations for antibody response to Borrelia burgdorferi demonstrated remarkable elevation of IgG antibody and no specific IgM response. These results were confirmed by immunoblotting reactivity with the bands p83/100, p58, p43, p41, p39, OspA, p30, OspC, p21, and p17. We subsequently learned that the child had suffered a tick bite followed by an EM 5 years earlier and had been treated with trimethoprim/sulfamethoxazole at that time. The patient now was given intravenous ceftriaxone, 2 g daily for 14 days. In the absence of clinical improvement 3 weeks later a knee joint aspiration was performed which resulted in a positive polymerase chain reaction (PCR) test for B. burgdorferi DNA (OspA) in the synovial fluid. The patient fully recovered 2 months later without further treatment. The case indicates that the latency period between EM and onset of LA may last up to 5 years. In addition to serologic test methods, analysis of synovial fluid using PCR may be decisive for making the final diagnosis of LA.
PMID: 10885847 [PubMed – indexed for MEDLINE]
How Lyme Disease is Misdiagnosed as Attention Deficit Disorder or ADD
by Laura Pickford Ramirez
Dr. Charles Ray Jones, the world’s leading pediatric specialist on Lyme Disease calls it “the second great imitator.” (Syphilis is the first.) Since it can affect the entire body in a myriad of ways, it often mimics Attention Deficit Disorder (ADD), rheumatoid arthritis, autism, depression, chronic fatigue, multiple sclerosis and more. If this disease is not diagnosed properly it can become chronic and cause neuralgic, psychiatric, cardiac and arthritic problems. Left untreated, it can lead to heart block, seizure disorder and brain destruction. Although in rare cases, people have died from it, most live a life of constant suffering.
Lyme Disease Treatment
Lyme disease is treated with antibiotics. Since the organism, which causes Lyme has become increasingly hardy over the past thirty years, the treatment time is usually eight to ten weeks. If the bacteria is not completely eliminated, the symptoms will return. When selecting a physician to treat the disease, make sure he or she knows that contrary to what the American Academy of Pediatrics advises, it takes more than a three week course of antibiotics to eradicate the disease.
Dr. Charles Ray Jones, who is the world’s leading pediatric specialist on Lyme Disease, says that about 90% of his practice is comprised of patients with the disease. Although he is 73 years old and could retire, he works tirelessly because his services are so desperately needed. This kind and dedicated physician works ten hours per day, seven days per week and lives in an apartment above his office. He is currently training other doctors to diagnose and treat the disease. After learning of Dr. Jones’ commitment to his patients’ wellness, I concur with medical writer, Valerie Andrews, who calls him the “Albert Schweitzer of Lyme kids.”
Borreliosis During Pregnancy: A Risk for the Unborn Child?
To cite this article:
Ioannis Mylonas. Vector-Borne and Zoonotic Diseases. -Not available-, ahead of print. doi:10.1089/vbz.2010.0102.
Online Ahead of Print: October 6, 2010
Division of Infectious Diseases in Gynaecology and Obstetrics, 1st Department of Obstetrics and Gynaecology, Ludwig-Maximilians-University Munich, Munich, Germany. E-mail: firstname.lastname@example.org
Little is known regarding the possible harmful effects of Borrelia infections in pregnancy, since such a risk analysis is difficult to perform. Transplacental transmission of Borrelia burgdorferi has been documented in several animal studies. Therefore, it had been thought that fetal infection and teratogenicity was possible from B. burgdorferi, especially considering the similarities between Lyme borreliosis and syphilis. However, several clinical, serological, and epidemiological studies have failed to confirm a causal association between B. burgdorferi infection and a pregnancy adverse outcome. Moreover, there have been no reported cases of transmission of Borrelia via breast milk. However, the therapeutic approach to pregnant women with Lyme disease should be antibiotic treatment, according to the clinical manifestation and the timing of the tick bite. An effective vaccine is not yet available and the prevention of Lyme borreliosis depends on public and physician education, and appropriate antibiotic therapy during pregnancy.
The article outlines examples of a viral (varicella-zoster virus, VZV), a bacterial (Lyme borreliosis) and a parasitic (scabies) infection in pregnancy with their risk for the mother and/or child as well as their management…
…In case of Lyme borreliosis of the mother, adequate antibiotic therapy with amoxicillin prevents harm to the fetus. Doxycycline is contraindicated during pregnancy.
Full text available at http://www.springerlink.com/content/535g0hg3n1117685/
NEUROLOGICAL MANIFESTATIONS OF LYME DISEASE IN CHILDREN
Dorothy M. Pietrucha, M.D., P.A.
3318 Route 33
Neptune, New Jersey 07753
Study Identifies New Risk Factors for Dangerous Eye Complication of Juvenile Arthritis
Research suggests more kids with JIA may need intensive eye screenings to catch uveitis.
By Jennifer Davis
A large, new study conducted by an international team of researchers finds that more kids with juvenile idiopathic arthritis, or JIA, than previously recognized may be at high risk for uveitis, a devastating eye complication of the disease that causes blindness in up to 45 percent of cases.
Tick Talk note: Both arthritis & uevitis are symptoms of Lyme disease – this condition should be considered when examining a child with these types of symptoms….
Stroke in Children Due to Lyme Neuroborreliosis: Changes in Vessel Wall Contrast Enhancement
1. Axel Lebas MD,
2. Frédérique Toulgoat MD,
3. Guillaume Saliou MD,
4. Béatrice Husson MD,
5. Marc Tardieu MD
Article first published online: 1 DEC 2010
BACKGROUND AND PURPOSE
Neuroborreliosis is a rare cause of stroke in children. We aim here to demonstrate the diagnostic value of gadolinium-enhanced magnetic resonance imaging (MRI) for demonstrating vessel wall abnormality in a child with brainstem stroke.
We report here the case of an 8-year-old boy with cerebral vasculitis and stroke due to Lyme neuroborreliosis. Imaging studies revealed the presence of ischemic lesions in the pons and cerebellum, with focal stenosis of the basilar artery on magnetic resonance angiography and focal gadolinium enhancement of the basilar artery wall. Nine months after treatment, clinical outcome was favorable, with no enhancement of the basilar artery.
Gadolinium-enhanced MRI provided additional information facilitating the diagnosis of vasculitis in a child with Lyme neuroborreliosis and stroke. The location of vessel wall enhancement was correlated with the topography of the acute infarct, and the lack of vessel lumen obstruction supported the diagnosis of vasculitis rather than any other cause. J Neuroimaging 2010;XX:1-4.
Fantastic site on paediatric Lyme disease, Lyme in pregnancy, rashes & co-infections..
Lots of stuff helping school kids to prevent Lyme Disease
by the Lyme Disease Association of America
[Acquired nystagmus in a 12-year-old boy as initial presentation of Lyme disease.]
[Article in French] Samimi S, Salah S, Bonicel P.
J Fr Ophtalmol. 2011 Apr 13. [Epub ahead of print]
Service d’ophtalmologie, centre hospitalier régional d’Orléans, 14, avenue de l’Hôpital, 45067 Orléans cedex 02, France.
We report the case of a 12-year-old boy presenting with acquired horizontal nystagmus, headaches, and vertigo. CT, MRI, viral tests, and the Lyme disease test were at first negative. We made the diagnosis of neuroborreliosis based on a repeated Lyme disease test and lumbar puncture revealing intrathecal synthesis of specific antibodies. Adjusted antibiotic treatment led to complete disappearance of symptoms. Lyme borreliosis is difficult to diagnose and should be sought in case of unusual neuro-ophthalmic signs, especially in children.
Copyright © 2011 Elsevier Masson SAS. All rights reserved.
PMID: 21496946 [PubMed – as supplied by publisher]
Pregnancy and Lyme Disease
Ankle arthritis in a 6-year-old boy after a tick bite – a case report.
Randsborg PH, Naess CE. Open Orthop J. 2011 May 2;5:165-7.
Source Department of Orthopedic Surgery, Akershus University Hospital, 1478 Lørenskog, Norway.
Monoarthritis of the ankle is a rare condition in children, and is most often caused by a bacterial infection. Lyme disease is endemic in southern Scandinavia, and diagnosis remains a challenge. The clinical presentation of Lyme disease varies greatly, and often with considerable delay between exposure and presentation.
We report a case of ankle arthritis in a boy who presented one year earlier with a tick bite on the dorsum of the foot. He was suboptimally treated with oral antibiotics for one week, and developed in the following months a painless limp. Radiographs revealed a severe arthritis of the right ankle joint with necrosis of the talus and deformation of the talocrural and subtalar joints. There was no history of malaise, fever or other systemic symptoms. He remains seronegative for antibodies against B. burgdorferi.
The suboptimal oral antibiotic treatment may have hindered the antibody production against B burgdorferi, while not being therapeutic, resulting in severe ankle arthritis due to seronegative Lyme disease.
Good article on protecting your kids from the dangers of Lyme Disease in Ireland:
http://www.parenthood.ie/parenting/toddlerhood/protect-your-child-from-ticks-and-lyme-disease.html (page no longer available)
Also an article written by Tick Talk Ireland:
[Ocular Lyme disease occurring during childhood: Five case reports.]
J Fr Ophtalmol. 2011 Jun 20. [Epub ahead of print]
Sauer A, Hansmann Y, Jaulhac B, Bourcier T, Speeg-Schatz C.
Service d’ophtalmologie, nouvel hôpital civil, CHU de Strasbourg, BP 426, 67091 Strasbourg cedex, France.
INTRODUCTION: Lyme borreliosis (LB) is the most common human tick-borne disease in the Northern hemisphere. The various ophthalmologic manifestations of Lyme borreliosis (LB) during childhood are discussed in this paper.
PATIENTS AND METHODS: Six children with LB-associated ocular manifestations were treated between 2000 and 2010 in the ophthalmology department of Strasbourg University Hospital (an endemic area). Medical history, ocular and systemic clinical findings, determinations of antibodies related to Borrelia, as well as exclusion of other causes were the diagnosis criteria.
RESULTS: Two cases of uveitis, two cases of abducens palsies, one case of optical neuropathy, and one case of orbital myositis associated with LB were diagnosed. Systemic findings, such as arthritis, rash, or erythema migrans were mentioned in all cases. Two children also complained of severe knee arthritis. Determination of antibodies was positive in all patients. They were all treated with antibiotics adjusted to individual circumstances and some of them (two cases of uveitis and one of optic neuropathy) also had anti-inflammatory treatment. Resolution of ocular signs, with no relapse, was observed in all patients within two to 12 weeks.
CONCLUSION: For any unexplained ocular symptom, even in children, LB should be taken into account, especially in endemic areas. Such patients should undergo serological testing. If the clinical presentation is suggestive of LB, a course of oral antibiotics should be used. All in all, permanent defects are extremely rare during the childhood period, even following long-term manifestation at an early age.
Copyright © 2011 Elsevier Masson SAS. All rights reserved.
PMID: 21696850 [PubMed – as supplied by publisher]
Dr Cameron talks about neuropshyciatric problems in children
Lyme Disease in Preganncy – slide show by Dr Sarah Chissell
Treating GI Lyme Disease in Children
Martin D. Fried MD, Pediatric Gastroenterology and Nutrition explains what GI Lyme disease is and how it can be treated in children and in grown ups.