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Arch Pediatr. 2019 Apr;26(3):133-137. doi: 10.1016/j.arcped.2019.02.010. Epub 2019 Mar 15.

Lyme neuroborreliosis in children: Report of nine cases and a review of the literature.

Author information

1
Service de microbiologie, hôpital Necker-enfants-malades, Assistance publique-hôpitaux de Paris, 149, rue de Sèvres, 75015 Paris, France. Electronic address: guet-revillet.h@chu-toulouse.fr.
2
Groupe de pathologie infectieuse pédiatrique (GPIP), CHU de Lenval, hôpitaux pédiatriques, 57, avenue de la Californie, 06200 Nice, France; Association clinique et thérapeutique infantile du Val-de-Marne (ACTIV), 27, rue d'Inkermann, 94100 Saint-Maur-des-Fossés, France; Centre de recherche clinique, centre hospitalier intercommunal de Créteil, 40, avenue de Verdun, 94010 Créteil cedex, France; UMR 955, GRC, groupe d'étude des maladies infectieuses néonatales et infantiles (GEMINI), université Paris Est, IMRB Institut Mondor de recherche biomédicale, 94000 Créteil, France.
3
Service de pédiatrie, centre hospitalier Compiègne-Noyon, 8, avenue Henri-Adnot, ZAC de Mercières 3, 60200 Compiègne, France.
4
Unité policlinique pédiatrique, hôpital Bicêtre, 8, rue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France.
5
Groupe de pathologie infectieuse pédiatrique (GPIP), CHU de Lenval, hôpitaux pédiatriques, 57, avenue de la Californie, 06200 Nice, France; Service de pédiatrie, centre hospitalier de Versailles, 177, rue de Versailles, 78150 Le Chesnay, France.
6
Service de pédiatrie, centre hospitalier de Versailles, 177, rue de Versailles, 78150 Le Chesnay, France.
7
Service de pédiatrie, centre hospitalier de Chambéry, place Lucien-Biset, 73011 Chambéry, France.
8
Service de pédiatrie 1, hôpital de Hautepierre, 1, avenue Molière, 67200 Strasbourg, France.
9
Service de microbiologie, hôpital Necker-enfants-malades, Assistance publique-hôpitaux de Paris, 149, rue de Sèvres, 75015 Paris, France.

Abstract

Lyme neuroborreliosis is a bacterial infection caused by the dissemination and proliferation of a Borrelia species in the central nervous system. Neuroborreliosis occurs after transmission of the pathogen from an infected tick to a human host during a tick bite. We report nine cases of pediatric neuroborreliosis collected by the National Observatory of Pediatric Bacterial Meningitis in France between 2001 and 2012. The nine children, aged 4-13 years, were identified in northern and eastern France and had the following clinical features: meningeal irritation alone or with facial palsy, or isolated facial palsy. All cases showed anti-Borrelia antibodies in cerebrospinal fluid or serum, or with a positive Borrelia PCR in the CSF. The outcome was favorable in all cases after a 2- to 3-week course of third-generation cephalosporin. On the basis of these nine pediatric cases, this study provides an update on the epidemiology, pathophysiology, diagnostic strategy, and treatment of neuroborreliosis, with insight into the specific features of pediatric neuroborreliosis and the difficulties encountered in the diagnosis of this infection.

KEYWORDS:

Borrelia; Children; Lyme disease; Meningitis; Neuroborreliosis

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