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[Lyme disease in Upper Normandy: report of a hospital survey]
C Marguet1, M Rouillier-Saas, E Mallet
1Service de pédiatrie CHU Charles-Nicolle, Rouen, France.
Insights
This study surveyed pediatric Lyme disease cases in Normandy, finding neurological disorders in 11 of 15 children. Early symptoms were less common than secondary manifestations, highlighting the disease
Area of Science:
- Pediatric infectious diseases
- Neurology
- Rheumatology
Context:
- Study conducted in a densely wooded region of Upper Normandy, France.
- Focuses on children hospitalized in pediatric wards.
- Data collected between September 1988 and June 1997.
Purpose:
- To assess the prevalence of Lyme disease in children in Seine-Maritime and L'Eure.
- To identify common symptoms and neurological manifestations in pediatric cases.
- To document treatment approaches for childhood Lyme disease.
Summary:
- Fifteen pediatric Lyme disease cases were diagnosed, with 11 exhibiting neurological disorders.
- Common symptoms included erythema migrans, facial paralysis, and ocular disorders.
- Treatment involved amoxicillin or ceftriaxone, with some receiving corticotherapy.
Impact:
- Highlights the significant neurological burden of Lyme disease in children.
- Provides insights into symptom presentation and treatment outcomes in a specific geographic area.
- Contributes to understanding pediatric Lyme disease epidemiology and clinical features.
Abstract:
This study presents the results of a hospital survey on Lyme disease in children living in upper Normandy, a region that is quite densely wooded (with 18% forest areas and woods). The aim of this survey was to assess the prevalence of this disease in children from the Seine-Maritime and L'Eure, hospitalized in pediatric wards in the Seine-Maritime department, which includes Rouen, Dieppe, Fécamp, Elbeuf, and Le Havre. Fifteen cases of Lyme disease were diagnosed between September 1988 and June 1997. The children (6 girls and 9 boys) were aged between 5 and 14 years old. Only 7 subjects showed primary symptoms, while secondary symptoms were observed in 12 children. In the study population, a high prevalence (11 out of the 15 children) of neurological disorders was found. The following secondary symptoms were noted: 5 cases of erythema migrans, 2 cases of non-malignant cutaneous lymphocytoma, and 4 cases which in fact had previously displayed primary clinical signs (3 subjects with erythema migrans and 1 subject with non-malignant cutaneous lymphocytoma); 7 cases of uni- or bilateral facial paralysis, the most frequent neurological manifestation with or without lymphocytic meningitis; 1 case of central vestibular syndrome with a hyperalgesic meningoradicular reaction in the vicinity of the tick bite; 1 case of peripheral radicular involvement and intense pain in the left lower limb; 4 cases of ocular disorders (3 diplopias, 1 bilateral conjunctivitis complicated by kerato-uveitis, 1 bilateral complete cecitis). Only 10 child had rheumatological symptoms, i.e., Lyme arthritis of the right knee. Treatment consisted of amoxicillin (10 children) administered at a dosage of 50 to 100 mg/kg/d over a period ranging from 10 days to 1 month, or ceftriaxone (7 children) at a dosage of 50 to 100 mg/kg/d administered intravenously over a period ranging from 8 days to 3 weeks. Two of the children received combined antibiotic therapy, and 5 subjects had adjunct corticotherapy.