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J Pediatr ; 109(5): 753-8, 1986 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-3772655

RESUMO

We report 25 children with oligoarticular arthritis associated with Lyme disease. There were 16 boys (male/female ratio 1.8:1); ages ranged from 2 to 15 years. Thirteen (52%) children had no history of erythema chronicum migrans or other rash. Thirteen had temperatures as high as 41 degrees C for up to 2 months before the onset of arthritis. Twelve recalled definite tick bites. Ten (40%) children, of whom seven had no history of rash, were hospitalized for presumed septic arthritis. Another four had diagnoses of pauciarticular juvenile rheumatoid arthritis for as long as 3 years. Seven patients had less acute, recurrent episodes of synovitis. Two children had seventh nerve palsies 2 months before onset of arthritis. All patients had antibodies to the Lyme spirochete. In 14 patients, synovial fluid white blood cell counts ranged from 180 to 97,700/mm3 (greater than or equal to 76% polymorphonuclear leukocytes). Antibiotic therapy was effective in all patients; in 13, orally administered therapy alone resulted in elimination of synovitis and recurrent attacks. Lyme arthritis may be confused with acute bacterial septic arthritis or recurrent "pauciarticular juvenile rheumatoid arthritis," particularly when there is no history of erythema chronicum migrans.


Assuntos
Artrite Infecciosa/diagnóstico , Doença de Lyme/diagnóstico , Adolescente , Antibacterianos/uso terapêutico , Anticorpos Antibacterianos/análise , Artrite Infecciosa/tratamento farmacológico , Artrite Infecciosa/etiologia , Artrite Infecciosa/imunologia , Contagem de Células Sanguíneas , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Doença de Lyme/tratamento farmacológico , Doença de Lyme/imunologia , Masculino , Penicilinas/uso terapêutico , Recidiva , Dermatopatias/etiologia , Líquido Sinovial/citologia , Sinovite/etiologia
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