Childhood Lyme arthritis: experience in an endemic area.
Publication/Presentation Date
11-1-1986
Abstract
We report 25 children with oligoarticular arthritis associated with Lyme disease. There were 16 boys (male/female ratio 1.8:1); ages ranged from 2 to 15 years. Thirteen (52%) children had no history of erythema chronicum migrans or other rash. Thirteen had temperatures as high as 41 degrees C for up to 2 months before the onset of arthritis. Twelve recalled definite tick bites. Ten (40%) children, of whom seven had no history of rash, were hospitalized for presumed septic arthritis. Another four had diagnoses of pauciarticular juvenile rheumatoid arthritis for as long as 3 years. Seven patients had less acute, recurrent episodes of synovitis. Two children had seventh nerve palsies 2 months before onset of arthritis. All patients had antibodies to the Lyme spirochete. In 14 patients, synovial fluid white blood cell counts ranged from 180 to 97,700/mm3 (greater than or equal to 76% polymorphonuclear leukocytes). Antibiotic therapy was effective in all patients; in 13, orally administered therapy alone resulted in elimination of synovitis and recurrent attacks. Lyme arthritis may be confused with acute bacterial septic arthritis or recurrent "pauciarticular juvenile rheumatoid arthritis," particularly when there is no history of erythema chronicum migrans.
Volume
109
Issue
5
First Page
753
Last Page
758
ISSN
0022-3476
Published In/Presented At
Eichenfield, A. H., Goldsmith, D. P., Benach, J. L., Ross, A. H., Loeb, F. X., Doughty, R. A., & Athreya, B. H. (1986). Childhood Lyme arthritis: experience in an endemic area. The Journal of pediatrics, 109(5), 753–758. https://doi.org/10.1016/s0022-3476(86)80688-6
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
3772655
Department(s)
Department of Pediatrics
Document Type
Article