Lyme borreliosis in children

Abstract

The Czech Republic is an important endemic area of Lyme borreliosis. Borrelia are transmitted by ticks and have an affinity for many organs and tissues (skin, nervous system, joints, myocardium, etc.). This is associated with a variety of clinical manifestations, with erythema migrans, neuroborreliosis and joint involvement being the most common in children. The basis of laboratory diagnosis is the detection of specific IgM and IgG antibodies, confirming contact with the infectious agent, not the activity of infection. Direct methods are of limited use mainly due to low sensitivity (PCR) or lack of clinical data (investigation of specific cellular immune response). A careful evaluation of the clinical picture, supported by laboratory test results, is the basis for diagnosis. In the early stages of the disease, the effect of antibiotic treatment is very good. An insufficient clinical response should lead to an extension of the diagnostic procedure to other, even non-infectious causes of the symptoms.