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Neuroborreliosis and tick-borne encephalitis – same vector, but different clinical course

Abstract number: 1733_996

Soltysova K., Smiskova D., Picha D., Sojkova N., Podojilova M., Roubalova K., Sedivy K., Maresova V.

Objectives: Aetiology of aseptic meningitis in childhood remains often unclear. Czech Republic is endemic area for Lyme borreliosis and tick born encephalitis. Both of them belong to the most common neuroinfections in children and have the same vector – a tick.

Aim of our retrospective study was to characterise dominant neurological symptoms in children with neuroborreliosis (NB) in comparison with tick born encephalitis (TBE).

Methods: 38 children (mean age 10 years) hospitalised in Bulovka University Hospital (2002–2006) with final diagnosis neuroborreliosis and corresponding number of age-matched children suffering from TBE were enrolled to the study. The diagnosis was established on the presence of intrathecal antiborrelial IgG synthesis and/or PCR positivity in cerebrospinal fluid (CSF). TBE diagnosis was determined on the presence of anti-TBE IgM in blood and signs of aseptic inflammation in CSF. Patients were screened for history of tick bite, ECM, clinical course, results of laboratory testing including CSF examination, EEG, neurological complication and sequelae. Patients were monitored at admission and after 1, 3 and 6 months. Statistical analysis was performed using a paired t-test.

Results: All NB children except one have signs of aseptic inflammation in CSF. NB patients were more likely to have mononeuritis (NVII in most cases), afebrile or subfebrile course of the disease, shorter duration of headache and absence of meningeal irritation. When compared to the children with NB and TBE, there was no significant difference in white blood cell count, C reactive protein level, red blood cells sedimentation rate, number of lymphocytes and neutrophils in CSF and total protein level in CSF. Length of hospitalisation was longer in the NB group due to antimicrobial therapy. No permanent sequelae were observed in both groups.

Conclusion: NB had mild afebrile course in children and facial palsy was the most frequent clinical syndrome. No permanent sequelae where observed when treated with correct antimicrobial therapy.

Supported by grant No. /2005-IV-GAUK of the Charles University Grant Agency

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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