title: Tick inoculation in an eyelid region: report on five cases with one complication of the orbital myositis associated with Lyme borreliosis.
abstract: OBJECTIVE
  To determine the frequency and dependence of Lyme borreliosis after tick infestation in the eyelid region.
  
  
  METHODS
  Five patients after tick inoculation were investigated by immunofluorescence assays for IgM and IgG system). Ophthalmologic evaluation of myositis was supported with MRI, laboratory, and internal clinical investigations.
  
  
  RESULTS
  Four children showed negative Borrelia serology after a bite from a tick. In one case the left abducens nerve palsy was found, which was diagnosed in MRI as a thickened left lateral rectus muscle. The diagnosis of myositis with positive Borrelia burgdorferi serology was consistent with Lyme borreliosis. Other laboratory examinations were negative. The symptoms were reduced after treatment with ceftriaxon.
  
  
  CONCLUSIONS
  Lyme borreliosis was found in one in five patients after tick infestation in the eyelid region. Antibiotic prophylaxis against Lyme borreliosis with ampicillin is recommended for children after a tick bite.
authors.affiliation: Kliniki Okulistycznej w Centrum Medycznym im R. Virchowa w Salzgitter. holak@freenet.de
authors.forename: Heinrich
authors.initials: H
authors.lastname: Holak
authors.forename: Nikolai
authors.initials: N
authors.lastname: Holak
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Huzarska
authors.forename: Sophie
authors.initials: S
authors.lastname: Holak
mesh_terms: D000818:Animals; D001733:Bites and Stings / Q000150:complications*; D015748:Borrelia burgdorferi Group / Q000302:isolation & purification; D002443:Ceftriaxone / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005143:Eyelids / Q000382:microbiology*; D006801:Humans; D008193:Lyme Disease / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D009801:Oculomotor Muscles / Q000382:microbiology; D016727:Orbital Pseudotumor / Q000209:etiology*; D012698:Serologic Tests; D013984:Tick Infestations / Q000150:complications; D013987:Ticks
chemical_list: D002443:Ceftriaxone