Signs & Symptoms Associated With
Signs & Symptoms Associated With
Lyme Disease in Children
Lyme Disease in Children
(Part 1 of 5 Total Pages)
There are well over 1,000 peer reviewed scientific studies documenting various signs and symptoms in patients with Lyme disease.
The (draft) list below focuses on and draws from the thousands of studies involving children (and some mixed children and adults) with Lyme disease. It is listed by the symptom's description.
After almost 3 years of research invested in this project already, I hope to soon have all the symptoms sorted into groups making them easier to find (some day). Help with sorting them is welcomed! AfterTheBite@gmail.com
Please click on the symptom to see the supporting documentation.
- Migratory pains and stiffness in joints
- Persisting joint involvement
- Muscle aches and pain
- Refractory arthritis
- Arthritis of the knee
- Lyme arthritis appearing as septic arthritis or juvenile rheumatoid arthritis
- Headaches- mild to severe (reported in over 90% of children)
- Brain diseases
- Night and day sweats
- Fatigue- mild (barely noticeable) to severe fatigue (bed ridden) often unrelieved by sleeping
- Fatigue with poor stamina
- Facial weakness
- Bilateral facial palsy (BFP)
- Wilting fatigue with some periods of energy in between episodes
- Myalgia
- Pruritis
- More difficult to identify in children
- Asymptomatic course in a large number of children
- In children the upper part of the body is more frequently affected (rash)
- Borrelial lymphocytoma most frequently located on the earlobe in children
- Idiopathic intracranial hypertension
- Highest rates of facial palsies are among children living in hyper endemic regions (5%)
- High cerebrospinal fluid (CSF) levels of mononuclear cells and albumin
- Lyme meningitis characterized by signs/symptoms similar to viral meningitis
- CSF concentration of proteins (more frequent or higher in children with Lyme meningitis)
- Concentration disorder
- Carditis more likely in children aged >10 years
- Children more likely to develop arthritis secondary to B. burgdorferi infection than adults
- Brief attacks of arthritis, particularly affecting the knee
- More likely to have arthritis as sole presenting symptom of disease
- Untreated Lyme arthritis associated with ocular and brain diseases
- Utero transmission of B. burgdorferi during pregnancy resulting in fetal involvement
- Further pediatric studies are needed
- Sore throats- often very painful
- Nausea
- Abdominal upset and/or pain
- Loss of appetite
- Anorexia
- Backache
- Hypotonia (floppy baby syndrome)
- Leg pain
- Nocturnal pain in back and legs
- Swollen and/or painful knee
- Swollen knee
- Chest pain (at least 70%)
- Acropapular dermatitis
- SENLAT Syndrome (aka TIBOLA/DEBONEL)
- Necrotic eschar of scalp
- Painful lymphandenopathy
- Joint involvement- knee and ankle
- Swelling of ear
- Blue-coloured earlobe
- Painless ear swelling with redness
- Pinna- deformed and floppy
- Enlarged, nontender jugulodigastric node
- Thickening of soft tissues with increased echogenicity and hyperemia
- Inflammation of the auricular cartilage
- Auricular chondritis
- Local itching or burning of rash
- Erysipelas may be confused with Lyme EM rash
- Similar to relapsing polychondritis
- Deformity of the pinna
- Weak gag and cough reflexes
- Auricular chrondritis
- Personality changes
- Erythema of ipsilateral surrounding face and jaw
- Problems with schoolwork (not seen previously)
- Dizziness or a floating feeling (vertigo)
- Shortness of breath
- Ataxia
- Ataxia
- Cerebellar ataxia
- Meningeal involvement
- Massive and rapid weight loss
- Vomiting
- Gastroenteritis
- Fever and Chills
- Asthenia
- Headache (severe)
- Torticollis
- Simple partial seizures
- Diffuse leptomeningeal inflammation
- Tiredness
- Hyperintense cervical cord lesion
- Upper-airway infection
- Hypotonia
- Dysarthria
- Weak gag and cough reflexes
- Hyperintense lesions
- Fluid-attenuated inversion recovery sequences on left posterior arm of the internal capsule
- Fluid-attenuated inversion recovery sequences in the medulla oblongata
- Fluid-attenuated inversion recovery sequences on subcortical occipital and parietal region
- Localized marrow edema
- Leptomeningeal and root enhancement
- Unexplained neurological symptoms
- Meningoencephalitis
- Meningoradiculitis
- Encephalomyelitis
- (100)
- Dysarthia (difficult or unclear speech)
- Palpitations
- Syncope
- Excessive thirst
- Tourette's syndrome
- Inappropriate laughter
- Disorientation
- Noise sensitivity
- Pain or sensitivity in teeth
- Restricted mandibular opening
- Absence of lip notch
- Tinnitus
- Tingling
- Numbness
- Irritability
- Light sensitivity (indoors or out)
- Iridocyclitis
- Uveitis intermedia
- Abducens palsies
- Optical neuropathy
- Orbital myositis
- Conjunctivitis
- Infestation of eyelashes
- Forgetfulness
- Stiff neck
- Neck stiffness
- Neck pain
- Weakness
- Inability to think clearly
- Dementia
- Attention deficit disorder (ADD)
- Attention deficit hyperactivity disorder (ADHD)
- Cognitive Impairments
- Insomnia
- Hypersomnia
- Poor concentration
- Malaise
- Lethargy
- Acute hip pain
- Marrow edema
- Joint swelling
- Arthritis
- Ankle arthritis
- Oligoarthritis
- Monoarthritis
- Monoarticular arthritis
- Pauciarticular arthritis
- Temporomandibular joint effusion- TMJ
- Bed wetting
- Bladder pain
- Urinary urgency
- Testicular pain
- UTI's
- Menstrual irregularities
- Ocular motor disturbances
- Intracranial hypertension
- Keratitis
- Keratitis
- Nystagmus
- Problems with short-term memory
- Word finding problems
- Behavioral changes
- Difficulty thinking or expressing thoughts
- Poor working memory
- Panic attacks
- Depersonalization
- Outbursts- some violent
- Mood swings
- Meningomyeloradiculitis
- Nocturnal pain in back and legs
- Loud opening sound of the mitral valve
- Lumbar rigidity
- Thickened mitral valve with mild regurgitation
- Aseptic meningitis
- Stroke
- Myocardial muscle involvement
- Night terrors
- Autism spectrum disorder
- Ischemic and hemorrhagic lesions
- Auditory hallucinations
- Metamorphopsia
- Vasculitis
- Atypical location of lymphocytoma cutis
- Cerebral vasculitis
- Erythema migrans
- Multiple erythema migrans
- Borrelial lymphocytoma
- Acrodermatitis chronica atrophicans
- Acrodermatitis chronica atrophicans
- Difficulty learning new material in school
- Vision loss
- Blindness
- Optic neuritis
- Optic nerve involvement
- Bilateral papilledema along with right sixth cranial nerve palsy
- Photophobia
- Papilledema
- Papilledema caused by raised intracranial pressure
- Ptosis (drooping eye lid)
- Adie's pupil
- (200)
- Uvetitis
- Diminished reflexes
- Transient synovitis
- Continued synovitis
- Peripheral neuropathy
- Distal parasthesias
- Oculomotor nerve paresis
- Paraesthesia
- Dysfunctional and cosmetic problems
- Persistent facial nerve palsy
- Radicular pain
- Facial nerve paralysis
- Bell's palsy
- Peripheral facial palsy
- Trochlear palsy
- Trochlear palsy
- Facial nerve palsies
- Mild facial palsy
- Motoric disturbances
- Morning stiffness
- Depression
- Cranial neuropathy
- Anxiety
- Weight loss
- Neurologic signs and/or symptoms defined as possible sequelae
- Vomiting
- Myelopathy
- Poliomyelitis
- Cranial polyneuritis
- Cranial nerve palsies
- Hearing loss
- Cochlear inflammation
- Myocarditis
- Transient myocardial dysfunction
- Heart block
- Complete antrioventricular block
- Stroke and stroke-like symptoms
- Transient focal neurological deficits
- Complete hemiparesis
- Paraesthesia
- Fevers and/or chills
- Recurrent episodes of vertigo
- Short stenoses at the branching site of the left middle cerebral artery (MCA)
- Circumscript areas of malperfusion
- Thromboembolic events
- Increased CSF cell count
- CNS vasculitis
- Stenosis in the left posterior cerebral artery consistent with vasculitic inflammation
- MCA lesions
- Advanced heart block
- Advanced heart block
- Neurodevelopment delay
- Considerably large number of cases diagnosed in areas not considered endemic
- Depressed ventricular systolic function
- Cardiopulmonary symptoms
- Carditis
- Spinal cord swelling
- Increased white cell count
- High level of inflammation (higher in boys studied)
- Altered gait- jerky, uneven, labored, limp
- Torticollis (wryneck)
- Seizures
- Partial complex seizure disorder
- Delayed onset of illness
- Organ system involvement
- One or more coinfections
- Antibiotic-refractory arthritis
- Lower frequencies of Treg cells
- Higher expression of activation coreceptors
- Less effective inhibition of pro inflammatory cytokines
- Immune responses excessively amplified
- Immune dysregulation
- Transverse myelitis
- Acute myelitis
- Meningitis
- Lymphocytic meningitis
- Opsoclonus-myoclonus
- Myoclonus
- Radiculopathies
- Sensory abnormalities
- Usual and unusual symptoms from patient to patient
- Lyme meningitis diagnosed in two-thirds of children with infectious meningitis in Lyme endemic area
- Some clinicians in an LD-endemic area do not follow guidelines for diagnosing children suspected to have Lyme disease
- Broad range of neurologic disorders
- Severe acute cerebellar ataxia
- Acute hemiparesis
- Autonomic dysfunction
- Elevated CXCL13 levels in CSF
- Pleocytosis in cerebrospinal fluid
- Rasmussen Syndrome
- Jarisch-Herxheimer Reaction
- Asymptomatic Lyme (B. burgdorferi) infection (no visible symptoms)
- Alice in Wonderland Syndrome
- ALDY- inflammatory disease of skin similar to morphea
- Skin- central paleness, scaling, wrinkling, dermal atrophy, slight pigmentation, and telangiectasia
- Seventh nerve palsy
- Lethargy
- Irritability
- Negative PCR does not exclude it
- Multiple sclerosis
- Guillain–Barré syndrome
- (300)
- Pseudotumor cerebri
- Cerebral vasculitis
- Focal neurological signs
- Mono- or oligoarthritis
- Eyes may be involved by keratitis, iridocyclitis, or uveitis intermedia
- Cardiac involvement may appear as AV block or carditis
- Acrodermatitis chronica atrophicans- a late skin manifestation of borreliosis
- Borrelial lymphocytoma, usually found at earlobes, nipples, or testicular sacks
- Fatigue without signs of mucous membrane involvement
- Summer flu
- Chronic headache
- Diminishing academic achievements
- In Spain, where the incidence is low, antimicrobial prophylaxis is indicated the after a tick bite
- TBE (tick-borne encephalitis) displayed more long-term complaints (ie, fatigue, headache and irritability) compared to Lyme
- Difficult to diagnose due to vague symptomatology
- Significantly higher frequency of disabilities detected in the TBE (tick-borne encephalitis) children
- TBE (tick-borne encephalitis) and Lyme cause consequences (eg, prolonged convalescence, worries and financial loss) for families
- Mildly tender mass in right pre auricular region- mass became larger, and overlying skin turned purple
- Mass appeared to reduce in size after doxycycline treatment, but then grew and turned erythematous
- Jarisch-Herxheimer's reaction at the beginning of treatment
- 26% had 1 or more complications
- 14% required a change in prescribed antibiotic therapy
- Ten percent of the patients had an adverse drug reaction
- Lyme borreliosis can affect almost all human organs
- Poor frustration management
- Neuropsychiatric impairments
- Serological tests have limited utility for follow-up
- Lyme disease shares many of the same physical manifestations as Autism Spectrum Disorder (ASD)
- All scores on SAP-O assessment improved after 6 months of antibiotic therapy.
- Morning stiffness
- Knee effusion with mild warmth and erythema of the joint
- Despite appropriate antibiotic therapy for Borrelia burgdorferi infection, skin lesion continued to enlarge
- Hip pain
- Limp
- Refusal to bear weight
- Monoarticular Lyme arthritis of the hip
- If presenting with nonspecific symptoms and signs, some children may elude diagnosis
- Pediatric tick-borne CNS infections are unexpectedly common
- Associated with unspecific symptoms
- Significantly more neurological symptoms outside the paretic area of the face
- Radiculitic pain
- Sensibility disturbances
- Pareses
- Pain
- Reported history of tick bite within 3 months before onset of symptoms was uncommon
- Elevated number of CSF mononuclear cells
- CSF albumin levels significantly high
- Treatment with oral doxycycline should be preferred to early corticosteroid treatment
- Solitary and multiple erythema migrans
- Abducens palsies
- Optical neuropathy
- Orbital myositis
- Severe knee arthritis
- For any unexplained ocular symptom, even in children, LB should be taken into account
- Ankle arthritis a year after a tick bite on the dorsum of the foot
- Severe arthritis of ankle joint with necrosis of the talus and deformation of the talocrural and subtalar joints
- Severe arthritis of ankle joint with no history of malaise, fever or systemic symptoms- seronegative for B. burgdorferi
- Suboptimal oral antibiotic treatment hindered the antibody production resulting in severe ankle arthritis
- Suboptimal treatment with oral antibiotics for one week developed in the following months a painless limp
- Acute swelling on the dorsum of foot
- Gradual limping gait
- Almost complete necrosis of the talus
- Calf muscles were atrophic
- Almost no ankle movement
- Equinovarus of the ankle
- One week oral antibiotics hindered antibody production against B burgdorferi, while not being therapeutic, due to short duration
- Seronegative Lyme arthritis due to early and inadequate antibiotic treatment
- Chronic Lyme disease cannot be excluded by the absence of antibodies against B. burgdorferi
- The typical rash, erythema migrans, affects only 50 % of children
- Onset of arthritis after a tick bite usually occurs within weeks or months, but as late as five years
- Recurrent synovitis and popliteal cysts
- All symptoms should be treated as early as possible to shorten the duration and prevent progression of the disease
- Tick bite in upper limbs in the majority of the cases
- Articular demonstrations
- 34 month old girl- Parvovirus B19, Epstein Barr virus(EBV), Borrelia IgM, and Herpesvirus 6 (HHV-6) DNA were positive
- Dermiswith inflammatory infiltrate, lymphocytes,neutrophils and eosinophils, perivascular localisation andtransendothelial migration, and presence of DNA of Borrelia burgdorferi, Parvovirus B19 and EBV
- A delayed hypersensitivity reaction to penicillin, with severe local manifestation, misinterpreted as panniculitis
- IL-17 was elevated in CSF in 49% of the patients with confirmed NB
- Significantly higher CSF levels of CXCL10, CCL22 and CXCL8
- Patients with early NB (Neuro-Borreliosis) had a short duration of symptoms and lower CCL22 levels in CSF than did the confirmed NB group
- Cytokine/chemokine levels were not correlated with clinical parameters or to levels of anti-Borrelia-antibodies
- Acquired horizontal nystagmus, headaches, and vertigo
- Adjusted antibiotic treatment led to complete disappearance of symptoms
- Lyme borreliosis is difficult to diagnose and should be sought in case of unusual neuro-ophthalmic signs
- Tachycardia
- Junctional tachycardia
- Arrhythmia resolved with intravenous ceftriaxone
- Lyme neuroborreliosis (LNB) is a serious but treatable disease
- The diagnosis of LNB poses a challenge to clinicians, and improved tests are needed
- CSF CXCL13 levels were significantly elevated in definite and probable acute NB in children
- Serum CXCL13 levels showed great fluctuations and were not significantly elevated
- General unspecific symptoms
- Antibodies directed to B. burgdorferi exclusively in cerebrospinal fluid
- New knowledge on BYS (Baggio-Yoshinari Syndrome) must be scattered to specialists, aiming to teach them how to diagnose this amazing tick-borne disease and avoid its progression to chronic irreversible sequels
- Ptosis, conjunctivitis
- Photophobia
- For children with Lyme facial palsy, early initiation of appropriate antibiotics is the optimal strategy
- Steroids should not be given
- (400)
- Exposure to tick bite was not captured in the vast majority of charts
- Subfebrile temperature
- Moderate intoxication
- Rare erythema (39.5%)
- Frequent cardiovascular disorders with development of Lyme carditis
- Further rise of hepatomegalia
- Development of meningeal symptoms
- Observed changes in the cytokine spectrum characterized by INF-gamma high levels
- Persistent pruritus
- Arthrobacter mysorens, a soil bacterium, was isolated from the collected skin (EM rash) and there was a positive serology for an advanced stage of Lyme borreliosis
- Retinal fibrous scars including the macular area
- "Pirate Face" (Bell's Palsy)
- Cerebral vasculitis and stroke
- Presence of ischemic lesions in the pons and cerebellum, with focal stenosis of the basilar artery on magnetic resonance angiography
- Focal gadolinium enhancement of the basilar artery wall
- Synovitis persisted for more than 1 year after 3–4 months of oral doxycycline and intravenous ceftriaxone or penicillin therapy
- Joint fluid and synovial samples obtained at synovectomy had negative PCR results for B. burgdorferi DNA and negative cultures for B. burgdorferi
- Even among patients who meet clinical criteria for antibiotic-refractory LA (Lyme arthritis), patient heterogeneity still exists, and several HLA-DR alleles contribute to disease severity
- Clinical features and methods for accurate diagnosis differ across world regions owing to different causative Borrelia species
- Mid-scapular back pain
- 24 hours of unilateral facial weakness
- Forward neck flexion elicited Lhermitte's sign (electrical sensation down the spine indicative of cervical spinal cord pathology such as inflammation)
- Lower motor neuron facial nerve palsy
- Bilateral increased lower extremity tone
- Muscle power was normal in all muscle groups tested
- Deep tendon reflexes were increased at the knees and ankles
- Left plantar response was extensor
- Reduced sensation to pinprick
- MRI of spine revealed increased T2-weighted signal in the spinal cord, mild spinal cord swelling, and diffuse gadolinium enhancement of the spinal meninges and proximal nerve root
- CSF protein level was elevated and concentration of CSF glucose was reduced
- Oligoclonal bands were present in the CSF, but not serum
- Meningoradiculitis
- CSF pleocytosis
- Presumptive diagnosis of transverse myelitis due to Lyme neuroborreliosis
- Erythema migrans is often slower spreading and appears less intensely inflamed in European cases
- Banworth's syndrome (lymphocytic meningitis, cranial neuropathy, and painful radiculitis)
- Chronic low-grade encephalitis
- Nonspecific symptoms such as fatigue, headache, and myalgias are common
- Specific testing for an immune response was suggestive but not conclusive for an acute infection
- There is no “gold standard” diagnostic test for Lyme neuroborreliosis
- Direct culture of Borrelia species and PCR are of low sensitivity
- ELISA, a relatively sensitive, but not specific test
- Western blot, which is specific, but not sensitive
- Sensitivity (tests) may be less than 40% in cases of acute stage 1 Lyme disease
- Lyme neuroborreliosis should be considered in the differential diagnosis of new neurological symptoms in children
- Timely recognition and treatment are imperative in order to facilitate recovery and to prevent long-term sequelae
- ASD/Lyme- improved speech, eye contact, sleep behaviors, and reduction of repetitive behaviors after 6 months antibiotic therapy
- Peripherally inserted central catheter-associated complication: 10% had a mechanical problem
- Peripherally inserted central catheter-associated complication: 1% had a venous thromboembolism
- Ceftriaxone-induced autoimmune hemolytic anemia
- (450)
- Chronic Lyme disease has been defined as persistent Borrelia burgdorferi infection requiring months to years of intravenous antibiotic therapy, oral antibiotic therapy, or both.
- Chronic Lyme disease advocates have started their own society
- “Lyme literate,” include physicians, patients, and laboratory personnel
- Chronic Lyme disease advocates have initiated legislation requiring insurance companies to pay for prolonged intravenous antibiotic therapy
- Motor/sensory radiculoneuritis
- Late Lyme disease is characterized by rheumatologic findings
- Chronic Lyme disease is caused by persistent infection with B burgdorferi unresponsive to standard courses of antibiotic therapy
- Patients with chronic Lyme disease may or may not have a history of objective findings consistent with Lyme disease
- Patients with chronic Lyme disease may or may not have positive B burgdorferi serology results
- Patients with chronic Lyme disease may or may not have visited an area where Lyme disease is endemic
- Patients with chronic Lyme disease need months to years of treatment with oral antibiotics, intravenous antibiotics, or both (frequently with multiple antibiotics simultaneously).
- Even after years of treatment, B burgdorferiinfection may persist.
- Diagnosing and treating chronic Lyme disease is based on the judgment and experience of the treating physician.
- Patients with chronic Lyme disease may never have had objective signs consistent with Lyme disease and may be seronegative for B burgdorferi antibodies.
- The average was one case of chronic Lyme disease for every 9 cases of Lyme disease
- Physicians used an average of 20 weeks (range, 8-52 weeks) of antibiotic therapy to treat patients in whom they diagnosed chronic Lyme disease
- Physicians report that other physicians had diagnosed chronic Lyme disease in many of their primary care patients
- “Lyme literate” physicians treat hundreds of patients with chronic Lyme disease each year, with months to years of antibiotics given orally or intravenously.
- Of the 284 patients, 269 (95%) became chronically infected with B burgdorferi because they were initially treated with a <60-day course of antibiotics.
- Thousands of patients with chronic Lyme disease who had B burgdorferi infection resistant to standard therapy.
- Oral/intravenous antibiotic therapy may be needed for months to years
- Two Connecticut physicians testified at a public hearing that they were diagnosing and treating hundreds of patients each year with chronic Lyme disease.
- A subpoena was issued to the IDSA claiming unfair trade practices because the IDSA did not acknowledge chronic Lyme disease in their Lyme disease treatment guidelines.
- Signs and symptoms (of Lyme) are different between the different age groups.
- 14 patients had no neurological signs at physical examination. In these patients, the number of subjective complaints was higher, and the time interval to diagnosis was longer compared with those with objective neurological abnormalities.
- 79% of paediatric neuroborreliosis patients presented with neurological signs, most often facial nerve palsy. 21% presented in an atypical way without neurological signs.
- Borrelia burgdorferi-associated lymphocytoma cutis on the ear
- The evidence continues to mount that Chronic Lyme Disease (CLD) exists and must be addressed by the medical community
- Despite the evidence, there are physicians who continue to deny the existence and severity of CLD, which can hinder efforts to find a solution.
- Recognizing CLD could facilitate efforts to avoid diagnostic delays of two years and durations of illness of 4.7 to 9 years described in the NIH trials.
- Persistent musculoskeletal pain, neurocognitive symptoms, or dysesthesia, often associated with fatigue” and were ill during a mean of 4.7 years after onset.
- There is no objective way to rule out an active infection.
- Poor functional status due to pain
- Denying the existence and severity of CLD will continue to hinder the efforts to find a solution.
- 10 to 16% of patients treated at the time of an erythema migrans rash remained symptomatic a mean of 30 months after treatment; results varied depending on the duration of antibiotics treatment.
- Patients infected with many other kinds of common bacteria—such as those that cause tuberculosis, bronchitis, or UTIs—can experience relapses after an initial course of antibiotic treatment fails or proves inadequate.
- Misdiagnosed with cellulitis
- Steere diagnosed three-quarters of patients with “fibromyalgia” or “chronic fatigue syndrome”
- Misdiagnosed as "arthralgia-myalgia syndrome,” primary depression, asymptomatic deer tick bites, osteoarthritis, and bursitis.
- Chronic Multisymptom Illness (MUI)- [having] at least one or more chronic symptoms from at least 2 of 3 categories of symptoms including musculoskeletal, fatigue, and mood cognition” that includes fibromyalgia, chronic fatigue syndrome, and Gulf War syndrome.
- Urgent need to address the mixed long-term outcome in children. 11% percent of children with facial nerve palsy had persistent facial nerve palsy causing dysfunctional and cosmetic problems at 6-month followup.
- Behavioral changes, forgetfulness, declining school performance, headache or fatigue
- Partial complex seizure disorder
- Children with prior cranial nerve palsy have significantly more behavioral changes (16% vs. 2%), arthralgias and myalgias (21% vs. 5%), and memory problems (8% vs. 1%) an average of 4 years after treatment compared to controls.
- Intermittent or persistent inflammation over a period of several years
- (PCR) results for B. burgdorferi DNA in synovial fluid (SF) are usually negative after oral and IV antibiotic therapy
- (PCR) results for B. burgdorferi DNA in synovial fluid (SF) are usually negative after cellular and humoral immune responses to B. burgdorferi antigens decline
- Cases of active infection have been observed during the post-antibiotic period
- The median duration from the initiation of antibiotics to the resolution of arthritis was 11 months (range, 4–44 months).
- Diffuse and patchy bluish red skin changes of different intensity and moderate swelling
- (500)
- Variation of the intensity changed with temperature and stasis.
- Paresthesia in leg and toes
- Intense edema of the dermis
- Reticulate and diffuse erythematous discolored skin with doughy turgor of leg
- Multiple oval-shaped whitish atrophic skin changes with erythematous margins present for 18 months
- Sclerotic skin changes were progressive
- Reddish swelling of earlobe present for over 6 months
- Sclerosis multiplex
- Problem with the diagnosis of atypical clinical cases in earlystages of LB
- Absence of immune response does not mean the absenceof borrelial infection
- Children often develop arthritis secondary to Lyme disease
- Optimal treatment of Lyme arthritis in pediatric patients remains ill-defined
- Persisting joint involvement 3 months after antibiotic initiation
- 99 children with Lyme arthritis- 23 developed refractory arthritis
- 200 patients- Prolonged intravenous antibiotic therapy is associated with low morbidity and no IVD-related mortality.
- Recurrent rather painless swelling of the knee- altogether four episodes lasting for 1-2 weeks each occurred over a period of 18 months.
- Slightly limited range of motion
- Chronical disease developed with alternate periods of swelling and almost complete remission
- Ongoing signs of synovitis
- Histopathological proven synovial cavernous juxtaarticular hemangioma
- Focal suprapatellar enhancement
- Blue-coloured earlobe
- The most common etiology for aseptic meningitis with PFNP (peripheral facial nerve palsy) was Bb (Lyme) infection
- Sclerotic skin lesions strongly resembling morphea or lichen sclerosus et atrophicus can beseen in patients with acrodermatitis chronica atrophicans (ACA).
- Highly significant association between morphea, serologic evidence of Borrelia infection, and high-titer antinuclear antibodies when disease onset was in childhood or adolescence.
- Early diagnosis of borreliosis would result in reduced human suffering and in economic gain.
- Seizures with regional leptomeningeal enhancement, acute transverse myelitis, meningoradiculitis with pain and paraesthesia and cranial nerve palsies other than facial nerve palsy can be the leading symptoms of children with neuroborreliosis.
- Lyme often presents with a wide variety of symptoms that may delay its diagnosis and present challenging patient management issues.
- Hispanic male presented with restricted mandibular opening
- MR of brain- foci of T2 prolongation in the cerebral white matter- one had an enhancing lesion with edema- three demonstrated nerve-root or meningeal enhancement
- 207 children with early disseminated Lyme disease- 33 (16%) had carditis, 14 (42%) had advanced heart block, including 9 (27%) with complete heart block.
- Four (12%) of 33 patients- children- with carditis had depressed ventricular systolic function, 3 (9%) of whom required mechanical ventilation, temporary pacing, and inotropic support.
- Complete resolution of rhythm disturbances and myocardial dysfunction occurred in 24 (89%) of 27 patients.
- Most children with carditis also had other systemic Lyme involvement.
- Children >10 years of age, those with arthralgias, and those with cardiopulmonary symptomswere more likely to have carditis
- Lyme meningitis is difficult to differentiate from other causes of aseptic meningitis
- May develop towards various clinical forms of chronic pathology
- Lymphocytic meningitis
- Clinical manifestation of LD were usual and unusual from patient to patient
- Hemiparesis
- Oculomotor nerve paresis
- Pediatric LA patients require >6 months to resolve synovitis
- Testing for Lyme disease remains unreliable
- Neuroborreliosis may be caused by different species of Borrelia burgdorferi
- The clinical presentation of neuroborreliosis in children may differ between geographical areas due to occurrence of different BB genospecies.
- The most common clinical presentations were symptoms of mild meningitis (75%) and/or facial nerve palsy (69%).
- Radicular pain was present
- Laboratory signs of meningitis were present
- Erythema migrans preceded neurological symptoms in only 27% of the children
- Evaluation of children with clinically suspected neuroborreliosis (NB) is difficult.
- (550)
- Persistent facial nerve palsy caused dysfunctional and cosmetic problems
- Nonneurological symptoms
- There has been a real increase in childhood neuroborreliosis during the last 12 years.
- Paresis of the facialis nerve and fever were more common among children than among adults.
- Patients with a diagnostic delay of less than 28 days had less sequelae than patients with a delay longer than 28 days.
- Brief attacks of joint swelling
- Radiculoneuropathy
- Encephalomyelitis
- Second- or third-degree atrioventricular block
- Frequency of reported symptoms was highly variable across the youngest age categories
- Meningeal enhancement in addition to ischemic infarctions on brain magnetic resonance imaging
- Diffuse vasculitis on vascular imaging
- No serologic findings
- Vasculitis syndrome
- Significant deficits in cognition (short-term visual memory, short-term and delayed verbal memory, all forms of recognition memory)
- Worse attendance, grades, and subjective reports of memory problems
- Deficits in visual memory exceeded deficits in verbal memory
- Adolescents with treated Lyme disease are at risk for long-term problems in cognition and school functioning.
- 8-year-old boy with a larval tick infestation
- The most frequent manifestation of neuroborreliosis in Europe is meningoradiculitis or Bannwarth's syndrome
- Persistent headache
- Persistent vomiting was the key clinical finding
- Acute cerebellar syndrome
- Meningitis
- Cerebrospinal fluid showed lymphocytosis, raised protein and decreased glucose
- Necrotic eschar surrounded by a perilesional erythematous halo
- Brief, often recurrent episodes of oligoarthritis
- Transient synovitis of the hip
- Confusion among physicians and patients is increasing regarding the diagnosis and treatment of Lyme borreliosis
- Specific involvement of B burgdorferi or other similar strains in the development or as a trigger of LS (Lichen Sclerosus)
- Lichen sclerosus shares similarities and common features with acrodermatitis chronica atrophicans (ACA), a chronic form of borreliosis
- Positive association between B burgdorferi infection and LS (Lichen Sclerosus) found evidence of the organism in 10% to 68% of cases
- Epidermis was usually thickened- Borrelia Lichen Sclerosus
- Borrelia Lichen Sclerosus- papillary dermis (early stage) occasionally revealed edema, yet more regularly, early fibrosis with an increase of fibrocytes and fibroblasts
- In later stages of Borrelia Lichen Sclerosus the number of fibrocytes and fibroblasts further increased
- Fibrosis and sclerosis (homogenized bundles of collagen without interposed fibrocytes) increased, whereas the inflammatory infiltrate decreased
- Very late stages- Borrelia Lichen Sclerosus- finally revealed a broad, homogenized eosinophilic band of collagen, ie, sclerosis without significant inflammatory infiltrate
- Borrelia Lichen Sclerosus-fibrosing dermatitis also involved the reticular dermis- simulating features characteristic of morphea at its various stages
- Spirochetes or their degenerative products were frequently located along or in between collagen bundles
- B. burgdorferi sensu lato detected in more than 60% of all LS (Lichen Sclerosus) cases- a significantly higher percentage (P = .001) in early (80%) than in late (33%) LS
- Errors in the diagnosis and treatment of Lyme disease in children are common
- Pauciarticular arthritis
- Chronic neuroborreliosis
- Recurrent or persistent arthritis that lasts for up to several years, presumably because of active infection
- Persistent B. burgdorferi infection, a condition they suggest requires long-term antibiotic treatment and may even be incurable
- Chronic Lyme disease clearly encompasses post–Lyme disease syndrome
- Chronic Lyme disease is used in North America and increasingly in Europe as a diagnosis for patients with persistent pain, neurocognitive symptoms, fatigue, or all of these symptoms, with or without clinical or serologic evidence of previous early or late Lyme disease.
- Persistently infected with B. burgdorferi- do not require objective clinical or laboratory evidence of infection as a diagnostic criterion
- Chronic B. burgdorferi infection can occur in the absence of antibodies against B. burgdorferi in serum
- Once the diagnosis of chronic Lyme disease is made, patients are commonly treated for months to years with multiple antimicrobial agents
- (600)
- Antibiotics may be prescribed either simultaneously or sequentially, and they are often administered parenterally.
- Physical health status of the patients was equivalent to that of patients with congestive heart failure or osteoarthritis
- Diagnosis is usually made clinically
- Late or severe disease requires intravenous ceftriaxone or penicillin G
- Neurological symptoms develop in 10-20% of children with borreliosis
- Clinical manifestation of LD were usual and unusual from patient to patient
- Acute ataxia
- Focal seizures- borreliosis could be responsible for triggering seizures
- Most common symptom of neuroborreliosis in children is motor dysfunction
- It is probable that borreliosis triggers seizures in children with EEG abnormalities
- Complete heart block (CHB) secondary to Lyme carditis
- Confusion/drowsiness
- Meningism
- Radiculopathy
- Sixth nerve palsies
- Peripheral neuropathies
- Admitted to hospital
- Significant neurological presentations other than or in addition to headache
- Meningoencephalitis
- Facial palsy without a rash or any other systemic symptoms
- Painful radiculopathy
- Chronic or recurrent headaches
- Vertigo
- Fatigue syndrome
- Weakness
- Acute hemiparesis episodes
- Capsulothalamic inflammation and a vasculitis
- Stroke-like episode
- Fetal neurological abnormalities associated with tick-borne diseases
- Bacteriological culture from blood, joint fluid or cerebrospinal fluid is very difficult
- Period of therapy depends on clinical form of borreliosis
- Chronic neuroborreliosis
- Adjacent muscular and soft-tissue edema
- Bilateral inguinal lymph nodes measuring up to 1 cm
- Hip pain
- Meningeal signs
- Inflammatory CSF changes
- Bannwarth's syndrome
- Aseptic meningitis
- Meningitis is not always accompanied by meningeal signs
- Cervical cellulitis with lymphadenitis
- Infectious uveitis caused by Borrelia in infancy
- Diagnosis of and therapy for borreliosis depend on the stage of the disease
- Deterioration of general well-being
- Brief episodes resembling typical absence seizures
- Acute facial nerve palsy in children was common
- Lymphocytic meningitis
- Juvenile idiopathic arthritis
- Seronegative Lyme arthritis
- Borrelial lymphocytoma of the glans penis
- (650)
- Bilateral & symetrical polyarthritis of big and small joints with fever and cutaneous eruption of trunk
- First-degree atrioventricular block
- Significantly elevated levels of C1q, C4, C3, and C3a in cerebrospinal fluid, but not in plasma
- Sudden sensorineural loss of hearing in the lower registers in both ears
- Inner ear involvement
- Popliteal cyst, with or without rupture
- Neuroborreliosis mimicking a space-occupying lesion in the brainstem
- Tumorous lesion
- Left abducens nerve palsy diagnosed in MRI as a thickened left lateral rectus muscle
- Diagnosis of myositis
- Tick infestation in the eyelid region
- Peripheral cranial nerves paralysis
- Symptoms of cerebrospinal meningitis
- Dermatosis
- Significant domination of cases with non specific symptoms
- Affected central and peripheral nervous system
- Symptoms of cerebrospinal meningitis
- Upper back pain
- Back stiffness and tenderness to palpation of the spinous processes
- Unexpectedly swelling, vasogenic oedema of spinal cord predominantly of grey matter compatible with poliomyelitis
- Lymphocytic pleocytosis & raised protein
- Extensive peripheral nervous deficit
- Mild and moderate residual neurological deficit
- Psychic problems
- Disturbances with sleep
- Psychic concentration, memory & mood
- Musculoskeletal complaints
- Whole body weakness
- Fatigue
- Tendomuscular pains
- Numbness
- Weakness in extremities
- Risidual pareses
- Rehab therapy as inpatient at hospital
- Required pain treatment in hospital
- Arthritis of left elbow joint
- Arthritis of left ankle
- Transientconjunctivitis
- Regional lymphadenopathy
- B.burgdorferi may cause chronic neuroborreliosissometimes after long periods of latent infection
- Arthritis of knee,shoulder, elbow, ankle, wrist and hip occurring weeks to months after the initial infection
- A wide range of neurologic abnormalities
- Ehrlichia meningoencephalitis
- Coinfection may require prolonging the duration of doxycycline therapy
- Cranial neuritis
- Lyme-associated pseudo tumor cerebri
- Cerebrospinal fluid pleocytosis consistent with Lyme meningitis
- Forty six per cent of patients were admitted to hospital
- Subacute meningitis with headache, fever, neck pain or loss of appetite
- Sequelae after confirmed NB occurs
- (700)
- Subacute meningitis
- Low-grade fever
- Headache
- Nausea and vomiting
- Neck stiffness
- Pain or other sensory or motor dysfunctions
- Remaining neurological symptoms
- Multiple skin lesions
- Unspecified systemic symptoms
- Headaches
- Muscle and articulation pains
- Weakness
- A mood depression
- Physiotherapy process usually lasting several months
- Positive Lyme CSF-PCR was found in only 1 patient (1 of 20, 5%) with Lyme meningitis
- Prolonged arthritis attacks
- Because of the limitations of laboratory testing for Lyme disease, diagnosis is based primarily on clinical findings.
- Chronic arthritis
- Meningitis
- Bell’s palsy
- Cranial neuritis
- Pancarditis
- Radiculoneuritis
- Encephalopathy- stage 3, chronic Lyme
- Polyneuropathy- stage 3 chronic Lyme
- Leukoencephalitis- stage 3 chronic Lyme
- Secondary annular lesions
- Myopericarditis
- Lymphocytoma
- Acrodermatitis chronica atrophicans in chronic Lyme
- Slight facial weakness
- Signs of slight-to-moderate facial motor dysfunction
- Optic neuritis
- Papillitis
- Posterior uveitis
- Cranial neuropathy
- Differential diagnosis- enteroviral meningitis
- Skin changes did not fully normalize
- Muscle edema
- Subcutaneous edema
- Myositis and adenopathy
- Lyme borreliosis is a common, potentially serious infection
- Lyme is still underdiagnosed and often poorly known by practitioners
- Atypical ocular manifestations
- Periodic cycle of acute and afebrile episodes
- Rash may be mistaken for such skin problems as hives, eczema, sunburn, poison ivy and flea bites
- Photophobia
- Dizziness
- Stiff neck
- Backache
- (750)
- Somnolence
- Problems with memory and difficulty concentrating
- Progressive weakness
- Mood swings
- Very irritable
- Personality change
- Chest pain is a very frequent complaint- about 70%
- Abdominal pain
- Arthralgia usually involving the knee and sometimes the wrist
- Palpitations
- Tingling
- Numbness
- Rashes that come and go- usually malar rashes
- Sore throats that are excruciatingly painful
- Children are thought to have functional problems
- Children present with central or peripheral nervous system manifestations frequently
- Encephalopathy
- Difficulty with memory, concentration and learning new material in school
- Excessive amount of fatigue
- A wake-sleep disturbance, either becoming hypersomniac or insomniac
- Stroke
- Sudden onset of a hemiplegia and aphasia
- Involvement of the optic nerve with an optic neuritis or a papillitis- resultant vision loss
- Peripheral neuropathy with distal parasthesias
- Diminished deep tendon reflexes
- CBC's are almost always normal
- Sed Rates of greater than 30 have occurred in only ten percent of the patients
- EEG's have been abnormal in one-third of the patients showing bilateral sharp waves and some slowing
- MRI's abnormal showing evidence of increased signal in the white matter
- Majority of children have had normal spinal fluid findings
- Usually no elevation of white cells
- Protein and sugars are normal
- Cultures are negative
- At least 50 percent show increased opening pressures (greater than 200, sometimes as high as 400)
- Loss of vision in left eye
- Diagnosis of Lyme disease is a clinical one
- Otitis media
- Sleeping twenty-four hours a day
- Pseudotumor
- Chronic headache for two years
- Severe pain in both thighs
- Sudden onset of headache with fever
- Progressive weakness of extremities
- Had to hold on to the wall while walking due to extreme weakness
- Misdiagnosed as Guillain Barre Syndrome
- Weakness, more so on the right than on the left, with a very mild right hemiparesis
- Still had hypoactive reflexes
- Excessively irritable
- Diaper rash non-responsive to any treatment
- Unable to talk
- (800)
- Unable to eat
- Persistently abnormal electroencephalograms
- Significant fall-off in school performance
- Requires remedial help
- Continues to have abnormal EEG's
- Performance in school fell off- had been an exceptionally good student
- Double vision
- Loss of vision
- Progressive weakness of the lower extremities with mild spasticity and brisk reflexes
- Back pain
- Headache
- Mood swings
- Depression
- Febrile convulsion
- Very irritable
- Looked pale
- Slowly responding to treatment, but continues to be irritable
- Weight gain
- Pain- difficult to treat
- Abnormal VERS
- Ultimately began to do better following four courses of intravenous antibiotics
- Sudden onset of a peroneal palsy
- A foot drop while driving the car
- Misdiagnosed as Juvenile Rheumatoid Arthritis
- Optic neuritis
- Optic discs were slightly swollen
- Hepatitis
- Problems with coordination
- Eye problems (cataracts)
- Heart defects
- Infants bitten very early in life will havemany of the same symptoms
- Loss and decline in developmental milestones
- Frequent fevers and illness early in life
- Mothers with Lyme disease should be treatedthroughout pregnancy
- Sense of air hunger or shortness of breath, dry cough
- Nightmares
- Developmental delays
- Learning disabilities
- Psychiatric problems
- Joint sensitivities
- Body pain
- New phobias
- Gastro esophageal reflux
- Skin sensitivity
- Recurrence ofseparation anxiety
- Floppiness with poor muscle tone
- Frequent URI
- Frequent ear and throat infections
- Frequent bronchitis
- Frequent pneumonia
- (850)
- Can mimic acute appendicitis
- Can mimic mesenteric adenitis
- Can mimic Crohn’s disease
- Can mimic colitis
- Can mimic irritable bowel syndrome
- Can mimic heartburn
- Urinary urgency and frequency
- Sudden lack of control in toilet trained child
- Return or new onset enuresis
- New psoriasis
- Frequent illnesses
- Dark circles under eyes
- Intermittent red, hot pinnae of ears
- Trouble falling asleep
- Hypersensitivity of skin, scalp and hair
- Hypersensitivity to noise, light, smell
- Alterations of taste
- Poor balance and coordination
- Suicidal thoughts
- Social withdrawal
- Decreased participation
- Uncharacteristic behavior outbursts
- New onset phobias, anxiety disorders
- Oppositional behaviors
- Obsessive compulsive disorders
- Deterioration in school performance in over 90%
- Difficulty with concentration and attention in school
- Easy distractibility as well as “brain fog” in over 80%
- Word finding problems in over 80%
- Short term memory difficulties in over 90%
- New onset ADD
- Defects in auditory and visualsequential processing
- Movement disorders – spasticity, ataxia, motor or vocal tics
- Cranial neuropathies, e.g. Bell’s Palsy or optic nerve
- Neuritis (can result in visual loss)
- Peripheral neuropathies – numbness and tingling, distal parasthesias, subtle weakness
- Peripheral motor weakness
- Partial complex seizures
- Apparent demyelinating disease (multiple sclerosis)
- Spinal cord involvement
- Pseudo tumor cerebri or increased intracranial pressure
- Papilledema
- Self mutilating behaviors
- Mistaken for "teen behaviors"- alcohol or illicit drug use
- New onsetpsychiatric disorder
- Pelvic pain
- Menstrual problems
- Ovarian cysts
- Testicular pain
- Fetal death in utero
- (900)
- Hydrocephalus
- Intrauterine growth retardation
- Fetal death at term (stillbirths)
- Cardiovascular anomalies
- Cortical blindness
- Sudden infant death syndrome
- Maternal toxemia of pregnancy
- Gestational Borreliosis associated with “sepsis” and death
- Neonatal hyperbilirubinemia
- Neonatal respiratory distress
- Chorioretinitis
- Papillitis
- Iridocyclitis
- Occlusion of the arteriae centralis retinae
- Neuritis retrobulbaris
- Neuroretinitis
- Acute bilateral C7 radicular pain
- Neck stiffness
- Acute transverse myelitis
- Osteolytic lesions
- Erosive arthritis
- Left sixth cranial nerve palsy
- Elevated intracranial pressure
- Markedly elevated cerebrospinal fluid leukocyte count and protein concentration
- Severe hypoglycorrhachia
- Cervical radiculitis
- Multiple organ involvement
- All were hospitalized for typical erythema migrans
- Acute upper respiratory tract infection
- Circulatory system symptom and manifestations of myocardial lesion
- Joint pain
- Eye symptom
- Headache, vomiting, drowsiness, neck stiffness and so on
- Less often reported a tick bite at the site of later skin lesion
- Ringlike lesion
- Abnormal findings on physical examination
- Nausea
- Vomiting
- Increased intracranial pressure
- Cerebrospinal fluid pleocytosis
- Increased intracranial pressure from neuroborreliosis- lead to blindness
- Pain in right lower extremity
- Mild hepatomegaly
- General symptoms
- Lyme arthritis
- Lymphadenosis cutis benigna
- Acrodermatitis chronica atrophicans
- Depression
- Headaches
- Meningitis
- (950)
- Facial nerve palsy
- Arthritic manifestations
- Isolated intracranial hypertension
- Secondary erythema (32% of patients)
- Neurological syndrome
- Cardio-vascular lesions (22%)
- Ocular lesions (13%)
- Hepatic lesions (8%)
- Neck pain
- Changes in behavior
- Pains in joints or muscles
- Numbness or funny sensations in nerves
- Problems with memory
- Problems with tear secretion
- Problems with pronunciation
- Sudden sensorineural hearing loss
- Neuronitis vestibularis
- Neurootological signs
- Vestibular neuronitis
- Low frequency hearing loss
- Very low CSF neutrophilic counts
- Prolonged duration of symptoms
- Flaccid appearance of the face (unilateral or bilateral)
- Joint fluid cell count was elevated with 91% neutrophils
- Benign intracranial hypertension
- Gonarthritis
- Multiple expanding annular erythema rashes (measured up to 17x10 cm)
- Chronic arthralgia
- Erythematous macules
- Red-purple, firm, indolent swelling of left nipple
- Cerebellar ataxia
- Multiple cerebellar enhancing lesions
- Diplopia
- Episodes of emesis
- Ocular motility revealed 10% bilateral abduction deficits
- Complete occlusion of right and partial occlusion of left transverse sinus
- Venous sinus thrombosis
- Necrotic skin wound
- Peripheral cranial nerves paralysis
- Cerebrospinal meningitis
- (990)
- Acute hemiparesis
- Large cerebral vessel occlusive disease
- Stroke-like episode
- Rash confused with nummular eczema, granuloma annulare, insect and spider bites, ringworm, or cellulitis
- Bilateral papilloedema with concomitant neuroretinitis
- Significantly more cognitive and psychiatric disturbances
- Memory problems, distractibility and school decline
- Marked fatigue (100%)
- Arthralgias (100%)
- Frequent and severe headaches (100%)
- 1,000
- Irritability/depression (94%)
- Short-term memory problems (94%)
- Schoolwork deterioration (94%)
- Myalgias (88%)
- Brain fog (88%)
- Neck pain (88%)
- Insomnia (82%)
- Distractibility (82%)
- Word-finding problems (82%)
- Severe flu (80%)
- Arthritis (38%)
- Moderate to severe sensory hyperacusis to sound (58%)
- Moderate to severe sensory hyperacusis to light (74%)
- Insomnia (77%)
- Word-finding problems (79%)
- Radicular pains (56%)
- Persistent neuropsychiatric complaints
- Difficulty with learning and focusing attention
- Interpersonal problems
- Anhedonia
- Ineffectiveness
- Negative mood
- Negative self-esteem
- Anxiety
- Conduct problems
- Learning problems
- Psychosomatic
- Impulsivity
- Hyperactivity
- Withdrawn
- Somatic complaints
- Anxious/depressed
- Social problems
- Thought problems
- Attention problems
- Delinquent behavior
- Aggressive behavior
- Internalization
- Externalization
- Eye and ear disease
- Encephalomyelitis
- Cardiomyopathy
- Uveitis
- Keratitis
- Meningitis
- Myopericarditis
- A V -block
- Conjunctivitis
- Radiculoneuritis
- Episodic arthritis
- 1,050
- Chronic arthritis
- Lethargy
- Irritability
- Stiffness of the neck
- Keratitis
- Iridocyclitis
- Uveitisintermedia
- Acrodermatitis chronica atrophicans
- Borrelial lymphocytoma usually found at earlobes, nipples or testicular sacks
- Summer flu
- Many patients will not recall a tick bite
- Patients may or may not have had erythema chronicum migrans
- Lymphocytic meningitis
- Cranial nerve palsies (most commonly Bell's palsy)
- Decreased sensation
- Weakness
- Absent reflexes
- Cardiac symptoms
- Weakness
- Fatigue
- Palpitations
- Varying degrees of atrioventricular block
- Mild pericarditis or myocarditis
- Arthritis
- Regional or generalized adenopathy
- Conjunctivitis
- Iritis
- Hepatitis
- Microscopic hematuria or proteinuria
- Subacute encephalopathy
- Axonal polyneuropathy
- Leukoencephalopathy
- Involvement of the optic nerve
- Inflammation
- Increased intracranial pressure
- Optic nerve abnormalities
- Decreased vision months after disease onset attributable to optic neuritis
- Lyme arthritis in child with HIV
- Acute peripheral facial palsy
- Myalgias
- Arthralgias
- Chills
- Abdominal pain
- Dyspnea (difficult or labored breathing)
- Cough
- Nasal congestion
- Sore throat
- Probability of a false-positive result is low
- Acute loss of neurological functions
- Increased intracranial pressure
- 1,100
- Early neuroborreliosis
- Chronic neuroborreliosis
- Miscellaneous disorders
- Meningitis
- Cranial or peripheral neuropathies
- Radiculalgia
- Encephalitis
- Myelitis
- Neuropathies
- Polyneuropathies
- Encephalopathies
- Encephalomyelitis
- Vasculitis
- Autoimmunology processes
- Acute arthritis
- Benign cutaneous lymphocytoma
- Chronic symptoms in 21%
- Visual symptoms
- No light perception
- Eye disc swelling
- Focal demyelinating lesions in the brain
- Non-malignant cutaneous lymphocytoma
- Central vestibular syndrome with a hyperalgesic meningoradicular reaction
- Peripheral radicular involvement and intense pain in lower limb
- Ocular disorders
- Diplopias
- Bilateral conjunctivitis complicated by kerato-uveitis
- Bilateral complete cecitis
- After single tick bite the disease developed
- Different organs and systems were involved
- Cardiac involvement
- Other neurologic symptoms
- Other musculo- skeletal symptoms
- Large effusion of knee joint 5 yrs. after tick bite
- Chronic form of neuroborreliosis with non-specific symptoms
- Long standing symptoms of severe weight loss and chronic headache
- Seizures
- Failure to thrive
- Acute hemiparesis as a result of cerebral ischaemic infarction
- Cerebrovascular course of neuroborreliosis
- Mono- or oligoarthritis with polyarticular arthralgias
- Opsoclonus-myoclonus
- Parainfectious process
- Paraneoplastic syndrome in association with neuroblastoma
- Cardiovascular
- Nonspecific symptoms
- Malaise
- Fatigue
- Headache
- Myalgia
- 1,150
- Arthralgia
- Morphea- PCR Confirmed
- Lichen sclerosus- PCR Confirmed
- Satellite cutaneous lesions- 16%
- Altered lymphocyte phenotypes and NK cells
- Isolated trochlear palsy
- Pseudotumor (zemel letter)
- Bilateral sensorineural hearing loss
- Spastic paraparesis
- Intense, lancinating, radicular pain- especially at night
- Endophtalmitis
- Episcleritis
- Acrodermatitis chronica atrophicans
- 1,162
- Year 1999 & Earlier
- Severe arthritis
- Flu-like symptoms with fever
- Borrelia lymphocytoma
- EM rash and Borrelia lymphocytoma
- ACA and circumscribed scleroderma
- Mild arthralgia
- Recurrent headache
- Concentration disturbance
- Persistent swelling of the ear lobe
- Herxheimer's reaction
- Aseptic meningitis
- Peripheral neuropathy
- Acute atrioventricular block
- Arthritis
- Encephalopathy
- Polyneuropathy
- Non-specific symptoms only
- Difficulties with sleeping
- Difficulty exercising
- Difficulties formulating ideas
- Difficulty in gym class
- Difficulties going to school
- Difficulties with judgment
- Appetite related problems
- Joint pain
- Muscle pain
- Numbness
- Fatigue
- Swollen joints
- Headaches
- Neck pain
- Memory problems
- Word finding
- Ischemic lenticular stroke
- Sudden deafness
- Vertigo
- EM without extracutaneous manifestations
- Ocular inflammation
- Keratitis
- Anterior uveitis
- 40
- Uveitis intermedia
- Decreased visual acuity
- Corneal scar
- Permanent loss of visual acuity
- Chronic anterior uveitis
- Acute anterior uveitis
- Inflammatory disorders ofthe meninges
- Inflammatory disorders of the cranial nerves
- Inflammatory disorders of the heart
- Transient follicular conjunctivitis
- 50
- Inflammatory lesions of all sites of the eye
- Intermediate uveitis
- Blindness
- Retinalproblems
- Papilloedema
- Optic nerve neuritis
- Squint
- Inflammatory eye lesions
- Transient conjunctivitis
- Other inflammatory eye lesions
- 60
- Ocular lesions other thantransient conjunctivitis
- Loss of vision 10 months after onset of arthritis of the knee
- Permanently reduced visual acuity
- Severe keratitis of upper third of both corneas
- Marked neovascularisation without intraocularinflammation
- Blurred vision
- Peripheral ulcerative keratitiswith abundant neovascularisation
- Intermediate uveitis withvitreitis
- Isolation of B burgdorferi from theinflamed iris
- Choroiditis
- 70
- Vitritis
- Blood-CSF barrier dysfunction
- IgM-class dominance in intrathecal humoral immune++ response
- Episodic oligoarthritis
- Chronic monoarthritis of the knee
- Lymphadenosis benigna cutis
- Lesions were situated on the earlobe and the nipple
- Cranial neuropathies
- Duration of symptoms was significantly longer among Lyme meningitis patients
- Papilledema
- 80
- Lyme meningitis patients had fewer white blood cells than viral meningitis patients
- Facial paresis- bilateral
- Contralateral facial paresis
- Facial weakness is oftenrapid in onset
- Painful meningoradiculoneuritis earlier described as Garin-Bujadoux-Bannwarth’s syndrome
- Unilateralor bilateral facial palsy
- Inflammatory CSF reactions
- Distinct feeling of discomfort
- Low-grade fever
- Jarisch-Herxheimer reaction
- 90
- Transient hemiparesis
- Infection-triggered vascular ischemia
- Retreated because of progression of facial palsy
- Excruciating radiculitic pain
- Remaining facial palsy with contracture at follow-up after 24 months
- Slight unilateral residual paresis
- Facialdiplegia
- Temporary subjective manifestations of paresthesias and hypoesthesias
- Fatigue
- Concentration impairment
- 100
- Supranuclear arm paresis
- Sensory deficits
- Cranial neuropathy may still progress after treatment
- Slight and severe posttreatment sequelae after unilateral palsy
- Slight residual palsy
- Permanent tissue damage caused by the initial infection
- Cranial polyneuritis
- Acute transverse myelitis
- Headache
- Bilateral facial nerve palsy
- 110
- Varying degrees of systemic symptoms
- Pseudotumor cerebri
- Carditis
- Initially misdiagnosed with septic arthritis, six of whom underwent arthrotomy
- Vertigo
- Facial Paralysis
- Arthritis of at least one knee
- Recurrent episodes of arthritis
- Chronic arthritis
- Radiculoneuritis
- 120
- Secondary erythema
- Mild associated flulike constitutional symptoms
- Facial palsy without pleocytosis
- Lymphocytic meningo-encephalitis
- Polyradiculoneuritis
- Pseudotumor cerebri
- Headache
- Papilledema
- Sixth nerve palsy
- Increased intracranial pressure
- 130
- Cerebrospinal fluid pleocytosis
- Articular problems
- Left facial paralysis
- Meningoradiculitis
- Presentation with low back pain only
- High frequency of episodic arthritis
- Vitritis
- Retinal vasculitis
- Neuroretinitis
- 140
- Chorioretinitis
- Optic neuropathy
- Focal retinochoroiditis
- Acute retinal necrosis syndrome
- Chronic ocular inflammation
- Bilateral seventh cranial nerve palsy
- Unusual cutaneous manifestations
- Erythema multiforme
- Persistent erythema
- Multiple cranial neuropathies
- 150
- Organ involvement
- Acute oligoarticular onset
- Chronic arthritis
- Aseptic meningitis
- Multiple erythema migrans lesions
- "Winter ears"- Borrelia lymphocytoma
- Brazil- identified 25 patients with Lyme disease (1997)
- Neuropathy of sensitive type
- Neurologic manifestations of Lyme disease are common in children
- Cranioneuropathies
- 160
- Meningoencephalitis
- Peripheral radiculoneuritis
- Cranial neuritis
- Encephalitis
- Myelitis
- Oculomotor nerve paralysis
- Nonspecific chronic conjunctivitis
- Keratitis
- Diminished corneal sensation
- Iritis
- 170
- Intermediate uveitis
- Perivasculitis
- Posterior uveitis
- Retinal haemorrhage
- Optic neuritis
- Optic disc oedema
- Sixth nerve paresis
- Chiasmal optic neuritis
- Perivascular inflammation
- Vasculitic lymphocytic inflammation
- 180
- Demyelination in periventricular white matter
- Brain MRI suggested malignancies
- Sudden hemiparesis
- Epileptic seizures
- Vasculitic lesions
- Progressive lymphedema of the left lower limb
- Erysipelas in the left lower leg
- Erythema nodosum in both legs
- Recurrentfever episodes
- Lung fibrosis
- 190
- Heartinsufficiency
- Chest pain atypical of coronary heart disease
- Facial redness suggestive of lupoid erythema
- Spiking fever persisted
- Vomiting
- Fatigue
- Fever
- Dizziness
- Progressive walking difficulties with ataxia and short gait
- Impairment of memory
- 200
- Impairment of taste
- Hearing impairment
- Sinusitis
- Brain CT showed an empty sella
- Urticaria
- Walking difficulties and fever episodes recurred
- Plasma and bone marrow specimenswere positive for B. burgdorfeh PCR
- Spleen was slightly enlarged
- Chronic liverstasis
- Mild pulmonary oedema
- 210
- Chronic left-sided subdural haematoma
- Generalized seizure
- Right pleural cavity fluid
- Central cystic lesion in the left kidney
- Memoryimpairment affecting verbal function
- Slightly impairedfluency of verbal expression
- Hyperactivity
- Paresisof the right lower limb
- Mild splenomegaly
- Spongiform changes
- 220
- Vasculitis
- Subacute encephalitis
- Perivascular inflammation
- Chronic Lyme disease encephalopathy
- Acute neurologic manifestations
- Meningitis with headache, mild neck stiffness
- Chronic neurologic manifestations
- Subacute encephalopathy manifested primarily by memory impairment
- Encephalomyelitis with spastic parapareses
- Abnormal CSF analysis
- 230
- Musculoskeletal manifestations
- Myositis
- Arthralgia
- Encephalitis
- Leukoencephalitis
- Facial palsies
- Meningitis
- Radiculoneuritis
- Epilepsy
- Cerebral vasculitis
- 240
- Severe dizziness
- Optic neuritis
- Neuritis
- Neuropathy
- Encephalopathy
- Transient hemiparesis
- Diplopia
- Tinnitus
- Bilateral facial palsy
- Polyradiculoneuritis
- 250
- Tetraparesis
- Meningeal irritation
- Ear pain
- Ear and face pain
- Joint pain and swelling associated with Crohn’s disease
- Headache
- Mental status changes
- Impaired taste
- Affects numerous organ systems
- Facial palsy
- 260
- Lymphocytic meningitis
- Flulike symptoms
- Burning
- Itching
- Pain
- Fatigue
- Malaise
- Headaches
- Arthralgias
- Myalgias
- 270
- Wide spectrum of clinical manifestations
- Nonspecific clinical symptoms
- Peripheral paresis
- Articular manifestations
- Cardiac manifestations
- Meningitis
- Encephalitis
- Craneal neuropathy
- Peripheral neuropathy
- Polyneuropathy
- 280
- Atrioventricular blockade
- High-grade (second- or third-degree) atrioventricular conduction defects
- Lymphocytic meningitis
- Cranial neuritis
- Radiculoneuropathy
- Encephalomyelitis
- Meningitis without cranial neuritis
- Radiculoneuropathy
- Encephalomyelitis
- More than one cranial nerve affected
- 290
- Hepatitis
- Panniculitis
- Chronic urticaria
- Arthritis
- Arthralgia
- Myositis
- Myalgia
- Multiple-site osteomyelitis
- Tendinitis
- Fibromyalgia
- 300
- Meningitis
- Myelitis
- Radiculitis
- Paresthesia
- Encephalitis
- Dizziness
- Memory impairment
- Encephalopathy
- Epilepsy
- Multiple cerebral infarcts
- 310
- Transient hemiparesis
- Hemisyndrome
- Ataxia
- Cephalalgia
- Involvement of III, VI, or VII cranial nerve
- Bilateral facial palsy
- Dementia
- Brain abscess
- Transient third-degree atrioventricular block
- Myocarditis
- 320
- Pancarditis
- Endocarditis
- Cardiomyopathy
- Iritis
- Chorioretinitis
- (Kerato) conjunctivitis
- Chronic photophobia
- Lymphadenopathy
- Prolonged fatigue
- Multiple organs frequently involved
- 330
- Recurrent fever episodes
- Chronic/recurrent arthritis
- Skin lesions
- Nodular lesion located on breast areola
- Expanding erythematous annular lesion located on the anterior face of thorax
- Mild constitutional symptoms common
- Acute peripheral facial palsy
- Neuroborreliosis
- Cogan's syndrome mimicking acute Lyme arthritis
- Acute pain
- 340
- Swelling
- Decreased range-of-motion
- Sensorineural hearing loss
- Interstitial keratitis
- Inflammatory arthritis
- Jarisch-Herxheimer reaction
- Serologic tests are often inaccurate
- Neurologic abnormalities
- Cardiac involvement
- Arthritis
- 350
- Arthralgia
- Acrodermatitis
- Joint involvement was usually characterized
- Facial palsy
- Atrioventricular block
- Arthritis
- Arthralgia
- Arthralgia
- Intermittent migratory arthralgias
- Myalgias
- 360
- Acrodermatitis chronica atrophicans
- Wide range of clinical symptoms
- Pseudotumor cerebri
- Vomiting
- Nausea
- Fatigue
- Papilloedema
- Increased intracranial pressure
- Lymphadenopathy
- Migrating erythema
- 370
- Peripheral neuropathies
- Encephalopathies
- Meningoencephalitis
- Serous meningitis
- Cardiovascular involvement
- Articular involvement
- Acrodermatitis
- Subacute or chronic central nervous system (CNS) manifestations
- Acute neuroborreliosis
- Severe multiple-site osteomyelitis
- 380
- Presence of spirochetes in a bone lesion
- Temporal mandibular joint pain
- Cervical lymphadenopathy
- Facial pain
- Headache
- Tinnitis
- Vertigo
- Decreased hearing
- Otalgia
- Sore throat
- 390
- Pleocytosis
- Meningitis
- Diffuse leptomeningeal enhancement in the absence of parenchymal lesions
- Sleep disturbance
- Papilledema associated with increased intracranial pressure
- Mild encephalopathy
- Lymphocytic meningitis
- Cranial neuropathy
- Meningoradiculitis (Bannwarth's syndrome)
- Peripheral neuropathy syndromes
- 400
- Pseudotumor cerebri-like syndrome
- Relapsing rate of 16%
- Paleness
- Myocarditis
- Cardiomyopathy
- Congestive heart failure
- Pericarditis
- Atrial and ventricular tachycardias
- Neck/back pain
- Hepatitis- subclinical
- 410
- Arthralgia
- Chronic skin efflorescences
- Neurologic disorders
- Rheumatic disorders
- Arthralgiae
- Sclerodermia circumscripta
- Neurologic symptoms
- Atypical Erythema migrans
- Sclerotic skin lesions
- Macular and urticarial lesions
- 420
- FUO- Fever of Unknown Origin
- Persistent or recurrent symptoms
- Headache
- Behavioral changes
- Facial palsy
- Papilledema
- Papilledema with diplopia
- Disturbance of sleep pattern
- Carpal tunnel syndrome
- Relapsing unilateral arthritis of the knee
- 430
- Uveitis
- Motor neuropathies
- Sensory neuropathies
- Cardiac arrhythmias
- Ventricular extrasystoles
- Conduction abnormalities
- Intermittent tachyarrhythmias
- Atypical pars planitis
- Conjunctivitis
- Chronic neuroborreliosis
- 440
- Parenchymal involvement
- Radiculoneuritis
- Acute facial paralysis
- Unilateral nonpalpable enlarged lymph nodes
- Meningoradiculitis (Bannwarth's syndrome)
- Paresis
- Radicular pain syndrome
- Myelitis
- Acute encephalitis
- Meningeal signs
- 450
- Inflammatory cerebrospinal fluid (CSF) changes
- Serious cardiac sequelae
- Serious rheumatological sequelae
- Serious neurological sequelae
- Clinical and subclinical signs of nervous system lesions
- Serous meningitis
- Multiple neuropathies running a subclinical course
- Conduction and rhythm disturbances [heart]
- Malaise
- Anorexia
- 460
- Lethargy
- Arthralgia
- Headache
- Roseola skin rash
- Abdominal pain
- Cough
- Sore throat
- Lymphocytosis cutis
- Lymphocytic meningitis
- Cerebellar signs
- 470
- Cranial polyneuropathy
- Radiculopathy
- Meningitis
- Pain in joints and soft tissues
- Myocarditis
- Iritis
- Panophthalmitis
- Inflammation of peripheral muscles
- Chronic erosive arthritis
- Demyelinating encephalopathy
- 480
- Polyneuritis
- Memory impairment
- Eosinophilic fasciitis
- Neurological signs
- Chronic synovitis
- Chronic neuroborreliosis
- Chronic Lyme arthritis
- Influenza-like symptoms
- Migratory joint pain
- Brief attacks of arthritis
- 490
- Keratitis
- Episodes of joint pain [10 years later]
- Marked fatigue [10 years later]
- Chronic encephalopathy
- Center of rash may become necrotic
- Neurologic disease
- Aseptic meningitis
- Radiculoneuropathy
- Decline in academic achievement
- Poor memory
- 500
- Behavior changes
- Fluctuating atrioventricular block
- Mild carditis
- Myocarditis
- First degree heart block
- Neurologic abnormalities
- Headache
- Stiff neck
- Radicular pain
- Motor deficits
- Frequent arthralgia
- Musculoskeletal pain
- Fatigue
- Neurologic involvement
- Severe carditis
- Persistent arthritis
- Aseptic meningitis
- Aseptic meningitis plus facial palsy
- Headache
- Fatigue
- Arthralgias
- Myalgias
- Acute transverse myelopathy
- Swelling and erythema of the right pinna
- Lymphadenosis benigna cutis
- Neurological complications
- Cardiac complications
- Locomotor disturbances
- Nonspecific inflammation
- Arthralgia
CONTINUED HERE- PART 2
PART 3 IS HERE
PART 4 IS HERE
https://sites.google.com/view/symptoms-of-lyme/childrens-symptoms/symptom-descriptions-children
PART 5 IS HERE
https://sites.google.com/view/symptoms-of-lyme/childrens-symptoms/childrens-symptom-statements