What Are the Symptoms of Lyme Disease in Children?

Lyme disease is a tick-borne Borrelia infectious disease, a natural epidemic disease caused by Borrelia burgdorferi. In 1985, the first case of this disease was found in the forest area of Heilongjiang Province in China. The main clinical manifestation of the disease is neurological damage. Meningitis, encephalitis, cranial neuritis, motor and sensory neuritis are the most common neurological damage. One stage of Lyme disease can be effective with antibiotics only. The use of antibiotics in the second and third stages does not help, especially the lack of specific treatments for neurological damage. It is characterized by chronic migratory erythema of the skin in the early stage, and neurological, cardiac, or joint lesions later appear. It usually develops in summer and early autumn. It can occur at any age, with slightly more men than women. The majority of cases are young adults, which is closely related to occupation. Field workers and forestry workers have a higher infection rate.

Basic Information

English name

Lyme disease

Visiting department

Infectious Diseases

Common causes

Borrelia burgdorferi is a pathogen

Common symptoms

Fatigue, chills, fever, headache, nausea, vomiting, joint pain

Causes of Lyme disease

Borrelia burgdorferi (Bergdorferi) transmitted by ticks is the pathogen.

Lyme disease clinical manifestations

Symptoms

(1) The incubation period is 3 to 32 days, with an average of about 7 days. Clinical symptoms can be divided into three phases.

(2) The first stage is mainly manifested by chronic migratory erythema of the skin, which is found in most cases. At the beginning of the disease, symptoms such as fatigue, chills, fever, headache, nausea, vomiting, joint and muscle pain, and meningeal irritation can also occur. Local and systemic lymph nodes can become swollen. Occasionally, splenomegaly, hepatitis, pharyngitis, conjunctivitis, iritis, or testicular swelling.

(3) In the weeks or months after the onset of the second phase , 15% and 8% of the patients showed obvious neurological symptoms and signs of heart involvement, respectively.

(4) Stage 3 Within several weeks to 2 years after infection, about 80% of patients develop joint symptoms of varying degrees such as joint pain, arthritis, or chronic invasive synovitis. Large joints such as knees, elbows, and hips are common, and tissues around small joints can also be affected. The main symptoms are joint pain and swelling, and there may be a small amount of fluid in the knee joint. Often recurrent.

2. Signs

(1) Skin lesions are often the first symptoms, which are characterized by chronic migratory erythema, beginning with red patches or pimples, and gradually expanding into ring-shaped lesions. It usually appears 3 to 32 days after the tick bite, and it usually occurs in the trunk, thighs, groin, and underarms.

(2) Nervous system lesions occur in about 15% of patients, and they occur simultaneously with the rash or 1 to 6 weeks after the rash subsides. It manifests as meningitis, encephalitis, chorea, cerebellar ataxia, meningeal irritation, coma, facial paralysis, or trigeminal neuralgia.

(3) Heart disease Seen in about 8% of patients, atrioventricular block, myocarditis, pericarditis, or pancarditis often occur after 3 weeks of skin lesions.

(4) Joint lesions are seen in about 60% of patients, involving large joints, especially the knee joint, and recurrent swelling and pain, and 10% of patients can become chronic arthritis.

(5) Other manifestations Fever, fatigue, myalgia, nausea, vomiting, conjunctivitis, iritis, lymph nodes, and liver and spleen.

Lyme disease test

Peripheral blood image was basically normal, the erythrocyte sedimentation rate increased slightly, serum cryoprecipitated immunoglobulin could be positive, and transaminase could be elevated.

Spirochetes can be detected from blood, cerebrospinal fluid, and diseased skin. Specific antibodies can be detected in patients' blood using immunofluorescence, immunotransfer and other methods. Pathogen isolation and specific antibody detection are of definite significance. Polymerase chain reaction (PCR) technology: detect blood, urine, cerebrospinal fluid, and skin specimens of patients with Lyme disease Treponema pneumoniae (Bb-DNA), and simultaneously detect the genotype of the infected strain.

Lyme disease diagnosis

Blood routine

The total number of white blood cells is normal, and neutrophils may increase slightly. ESR increased rapidly and rheumatoid factor was negative. Circulating immune complex was positive.

2.X-ray inspection

Swelling of the soft tissue around the affected joint can be seen, and a few patients have cartilage and bone invasion.

3. Pathogen isolation and specific antibody detection help diagnosis.

Lyme disease treatment

Antibiotic

It is effective for various diseases of Lyme disease.

(1) Tetracycline 4 times a day for 10 to 20 days. The drug of choice for early cases. Pregnant women, lactating women and children are prohibited.

(2) Amoxicillin 3 times a day for 14 to 21 days.

(3) Intravenous infusion of penicillin 1 to 2 times a day for 14 to 21 days.

(4) Other doxycycline, third-generation cephalosporin, etc. can be used.

2. Non-steroidal anti-inflammatory drugs

For the treatment of Lyme disease arthritis, such as indomethacin, fenbutide, etc.

3.Glucocorticoids

For patients with Lyme disease meningitis or carditis. Prednisone, gradually reduced to withdrawal after symptoms improved.

4. Patients with severe atrioventricular block

Should be actively symptomatic. Severe arthritis can be treated with synovectomy.