Persisting Lyme Disease in the Pediatric Population

Area of Science:

• Infectious Diseases
• Neurology
• Nuclear Medicine

Background:

• Lyme disease can present with persistent symptoms lasting over six months.
• Diagnosis of persistent Lyme disease is challenging, with varying sensitivities of diagnostic tests.
• Brain involvement is a concern in patients with chronic Lyme disease symptoms.

Purpose of the Study:

• To investigate persistent infection as a cause of persisting Lyme disease.
• To evaluate the utility of Brain Single-Photon Emission Computed Tomography (SPECT) imaging.
• To assess the efficacy of antibiotic treatment as a diagnostic and therapeutic tool.

Main Methods:

• Recruited 101 patients with persisting Lyme disease symptoms.
• Utilized Brain SPECT imaging to assess neurological involvement.
• Monitored patient responses to prolonged antibiotic treatments.
• Compared Western blot sensitivity against enzyme immunoassays.

Main Results:

• Brain SPECT scans were abnormal in 65% of patients.
• Western blot tests showed higher sensitivity than enzyme immunoassays.
• Antibiotic treatment resolved illness in most pediatric patients.
• A clinical diagnosis is supported by serologic and nuclear medicine findings.

Conclusions:

• Persistent Lyme disease is likely due to ongoing infection.
• Brain SPECT imaging and serological tests aid in diagnosis.
• Antibiotic therapy is effective for diagnosis and symptom resolution in children.
• A combination of clinical symptoms, serology, and imaging supports diagnosis and treatment.