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Lyme Disease (Ld; Lyme Arthritis)

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GENERAL INFORMATION

DESCRIPTION
Lyme disease is an inflammatory disorder characterized by a skin rash, followed in weeks to months by symptoms in the central nervous system (brain and spinal cord), cardiovascular system, and joints. This is named for Lyme, Connecticut, where it was first described. Body parts involved include the skin of the thighs, buttocks, or underarms; the central nervous system–including the brain, the coverings of the brain (meninges), and the spinal cord – and peripheral nerves; the heart and blood vessels; and any joint, especially in the neck and back.

Appropriate health care includes:

  • Self-care after diagnosis during treatment and convalescence.
  • Physician’s monitoring of general condition and medications.

SIGNS & SYMPTOMS
First stage:
A red papule (small, raised bump) on the skin of the thighs, buttocks, or armpits that grows as large as 5cm.

Later stages – any of the following:

  • Muscle aches and pains.
  • Fatigue.
  • Chills and fever.
  • Stiff neck with headache.
  • Backache.
  • Nausea and vomiting.
  • Sore throat.
  • Enlargement of the child’s spleen and lymph glands.
  • Migrating joint pain, eventually accompanied by redness and warmth.
  • Enlarged heart and heart-rhythm disturbances.

CAUSES
Unknown, but evidence suggests it is transmitted by the bite of a tiny tick, ixodes dammini. Many children report a tick bite at the site of the skin lesion 3 days to 3 weeks prior to the skin rash.

RISK FACTORS
Areas where ticks are numerous.

PREVENTING COMPLICATIONS OR RECURRENCE
Your child should wear protective clothing and use insect repellents in areas with ticks.

BASIC INFORMATION

MEDICAL TESTS

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.
  • Laboratory blood studies.

POSSIBLE COMPLICATIONS

  • Congestive heart failure.
  • Permanent joint deformity.
  • Permanent brain damage.

PROBABLE OUTCOME
The skin rash is curable in some children in 10 days with treatment, and this may prevent development of other symptoms. If not, symptoms in the joints, central nervous system, and cardiovascular system usually subside slowly over 2 to 3 years. Symptoms often recur after several years – without another tick bite.

TREATMENT

HOME CARE

  • Urge your child to use crutches to keep weight off affected joints, if necessary.
  • Heat relieves joint pain. Encourage the child to take hot baths or use heating pads, heat lamps, or whirlpool treatments.

MEDICATION

  • Your doctor may prescribe:
  • Penicillin or another antibiotic for at least 10 days, if a secondary bacterial infection develops in the affected skin.
  • Non-steroidal anti-inflammatory drugs.
  • Cortisone drugs to reduce the inflammatory response in the child’s heart or central nervous system.

ACTIVITY
Your child should rest in bed until symptoms of active inflammation subside. The child may read or watch TV and may resume normal activities gradually.

DIET & FLUIDS
No special diet.

OK TO GO TO SCHOOL?
Yes, but only when signs of infection have decreased, appetite returns, and alertness, strength, and feeling of well-being will allow.

CALL YOUR DOCTOR IF

Your child has symptoms of Lyme disease.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.

From the Complete Guide to Pediatric Symptoms, Illness & Medications by H. Winter Griffith, M.D. © 1989 The Putnam Berkley Group, Inc.; electronic rights by Medical Data Exchange.

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