Tick-borne Borrelia-meningitis in children. An outbreak in the Kalmar area during the summer of 1984.
Nine children, aged 5 to 11 years, with subacute or chronic meningitis were studied. Symptoms started during the summer season in all patients and in eight of the patients the disease began with a localized erythematous lesion (ECM), mostly in the face. In one patient only there was a history of an insect bite at the site of the erythema. The neurological abnormalities included aseptic meningitis, peripheral facial nerve palsy (5/9) and oculomotor nerve palsy (1/9). Most children complained of headache, fatigue, loss of appetite and had a low grade fever. High antibody titers to Borrelia spirochetes in serum and/or cerebrospinal fluid (CSF) were demonstrated by ELISA in eight of the nine patients and by indirect immunofluorescence assay (IFA) in three patients. All patients had a dramatic improvement in their general condition and became afebrile within three days of institution of i.v. penicillin G treatment (i.v. cefuroxime in one patient).
D001733:Bites and Stings / Q000150:complications*; D001899:Borrelia Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008581:Meningitis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D010400:Penicillin G / Q000627:therapeutic use; D013548:Sweden; D013987:Ticks
D010400:Penicillin G