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[Multilocular erythema migrans in borreliosis]

S Krischer1, H Ott, M Barker

  • 1Universitätskinderklinik der RWTH Aachen. skrischer@ukaachen.de

Klinische Padiatrie
|July 31, 2004
PubMed
Abstract

Insights

Multilocular erythema migrans, a rare skin manifestation of Lyme disease (borreliosis), can occur in children. Prompt antibiotic treatment effectively resolves these disseminated early infection symptoms.

Area of Science:

  • Pediatric infectious diseases
  • Dermatology
  • Vector-borne illnesses

Background:

  • Borreliosis is the most common childhood vector-borne disease.
  • Erythema migrans occurs in 80% of cases, but multilocular lesions are rare (2-18%).
  • Differential diagnoses include erysipelas, insect bite reactions, and drug eruptions, especially without a clear tick bite history.

Observation:

  • A 5-year-old boy presented with nine erythema migrans lesions on his face, trunk, arms, and legs.
  • The patient reported a tick bite three weeks prior to presentation.
  • Lesions were characterized by central pallor.

Findings:

  • Serological tests confirmed an acute Borrelia burgdorferi infection.
  • Oral amoxicillin treatment led to the resolution of skin manifestations within three days.
  • No signs of persistent borreliosis were observed during a six-month follow-up.

Implications:

  • Multilocular erythema migrans represents a disseminated early Lyme disease infection.
  • This manifestation can be associated with systemic symptoms like malaise, arthritis, carditis, headache, and meningeal signs.
  • Antibiotic therapy is crucial; intravenous administration is preferred for systemic involvement.

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