Paediatrics: Lyme disease

Lyme disease

•   Cause: spirochaete Borrelia burgdorferi transmitted by tick bite.

•   Age group: any age.

•   Incubation: 4–20 days.

•   Rash: erythematous macule at the site of the tick bite increases in size and forms a painless red lesion called erythema migrans.

•   Early time course (weeks): the symptoms of fever, headache, myalgia, arthralgia, and lymphadenopathy fluctuate over several weeks.

•   Later time course (months): dissemination of infection leads to cranial nerve palsies, meningitis, arthritis, or myocarditis.

•   Diagnosis: the clinical features and serology after 2–4wks.

•   Treatment: in the young child amoxicillin is used. In the child aged >8yrs use doxycycline. In those with heart or CNS disease use ceftriaxone.