Lyme Disease

Caused by the spirochete Borrelia burgdorferi

Clinical manifestations divided into 3 stages:

• early localized – characterized by erythema migrans rash; fever, malaise, headache, myalgia may also occur
• early disseminated – multiple erythema migrans; CN palsies, meningitis, conjunctivitis, systemic sx; carditis rare in children
• late disease – recurrent arthritis; CNS manifestations may also occur

Treatment:

• Early localized dz – doxycycline for children >8 yrs of age, amoxicillin for younger children, for 14-21 days.
• Early disseminated and late dz –IV abx for recurrent or persistent arthritis, CNS infection, carditis
• Treatment oferythema migransalmost always prevents development of later stages.

also see Tick-borne infections, prevention.

CHLA Board Review 2005