Lyme Meningitis in Children with Acute Serous Meningitis with no Clinical Signs of Lyme Borreliosis at Presentation
American Journal of Pediatrics
Volume 5, Issue 4, December 2019, Pages: 246-253
Received: Oct. 18, 2019;
Accepted: Nov. 5, 2019;
Published: Nov. 11, 2019
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Mojca Rozic, University Medical Center Ljubljana, Faculty of Medicine University of Ljubljana, Ljubljana, Slovenia
Andra Leskovec, Community Health Center Idrija, Idrija, Slovenia
Eva Ruzic-Sabljic, Institute of Microbiology and Immunology, Faculty of Medicine University of Ljubljana, Ljubljana, Slovenia
Maja Arnez, University Medical Center Ljubljana, Faculty of Medicine University of Ljubljana, Ljubljana, Slovenia
We evaluate the incidence of Lyme meningitis (LM) in children with acute serous meningitis and compare demographic, clinical and laboratory findings in children with LM and non-LM. During 2004-2005, 122 children fulfilled the inclusion criteria for this prospective clinical study (age < 15 years, meningitis, without typical clinical sign for Lyme borreliosis on admission). Antibodies to B. burgdorferi sensu lato were determined in blood and cerebrospinal fluid (CSF) and isolation of B. burgdorferi sensu lato was performed. LM was confirmed by isolation of B. burgdorferi sensu lato from blood and/or CSF and/or seroconversion to borrelial antigens and/or demonstration of borrelial intrathecal antibody production and/or history of erythema migrans. LM was probable in patients with positive but unchanging borrelial serum antibody titers. LM (83% confirmed, 17% probable) was established in 41 (34%) patients. Demographic, clinical and neurologic findings were comparable between the two groups. Fever and peripheral leukocytosis were more common in non-LM and inappetence and lymphocytic pleocytosis in LM. Borrelial serum IgM and/or IgG was found in 25%, seroconversion in 39%, IgG intrathecal antibody production in 5% and isolation of B. burgdorferi sensu lato from CSF and blood in 41% and 22% of patients, respectively. LM was found in 34% of children with acute serous meningitis. It is impossible to distinguish LM from non-LM only from medical history, clinical examination and basic blood and CSF investigations. For this reason, other signs of Lyme borreliosis and microbiological studies on Lyme borreliosis are compulsory.
Lyme Meningitis in Children with Acute Serous Meningitis with no Clinical Signs of Lyme Borreliosis at Presentation, American Journal of Pediatrics.
Vol. 5, No. 4,
2019, pp. 246-253.
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