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Lyme meningitis, the major cause of childhood meningitis in an endemic area: a population based study.
Arch Dis Child. 2012 Mar; 97(3):215-20.AD

Abstract

OBJECTIVE

To evaluate the epidemiology of infectious meningitis in children in a Lyme borreliosis (LB) endemic area, and to study how clinical and laboratory characteristics may distinguish between different types of childhood meningitis.

DESIGN

Retrospective, population based study.

SETTING

A paediatric department serving all children (62 000) in a costal LB endemic region of southwestern Norway.

PATIENTS

All children with cerebrospinal fluid pleocytosis aged 3 months to 14 years.

MAIN OUTCOME MEASURES

Epidemiological, clinical and laboratory characteristics of different types of childhood meningitis.

RESULTS

Infectious meningitis was diagnosed in 211 children (annual incidence 38/100 000). Lyme meningitis (LM) was identified in 142 children (67%), non-Lyme aseptic meningitis in 46 children (22%) and bacterial meningitis in 23 children (11%). Age, month of admission and clinical and laboratory characteristics differed between the groups. An aetiological agent was found in 89% of children. The positive predictive value for having LM if the child had facial nerve palsy or head and/or neck stiffness (meningism) as the only symptom was 97% for both variables. Symptoms of cerebral involvement or signs of systemic inflammation were rare in children with LM compared to children non-Lyme aseptic meningitis.

CONCLUSION

LM was diagnosed in two-thirds of children with infectious meningitis in this LB endemic area. Distinct clinical characteristics distinguished the majority of children with LM from children with non-Lyme aseptic meningitis and bacterial meningitis.

Authors+Show Affiliations

Department of Paediatrics, Stavanger University Hospital, Stavanger, Norway. tvda@sus.noNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22247243

Citation

Tveitnes, Dag, et al. "Lyme Meningitis, the Major Cause of Childhood Meningitis in an Endemic Area: a Population Based Study." Archives of Disease in Childhood, vol. 97, no. 3, 2012, pp. 215-20.
Tveitnes D, Natås OB, Skadberg Ø, et al. Lyme meningitis, the major cause of childhood meningitis in an endemic area: a population based study. Arch Dis Child. 2012;97(3):215-20.
Tveitnes, D., Natås, O. B., Skadberg, Ø., & Øymar, K. (2012). Lyme meningitis, the major cause of childhood meningitis in an endemic area: a population based study. Archives of Disease in Childhood, 97(3), 215-20. https://doi.org/10.1136/archdischild-2011-300526
Tveitnes D, et al. Lyme Meningitis, the Major Cause of Childhood Meningitis in an Endemic Area: a Population Based Study. Arch Dis Child. 2012;97(3):215-20. PubMed PMID: 22247243.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lyme meningitis, the major cause of childhood meningitis in an endemic area: a population based study. AU - Tveitnes,Dag, AU - Natås,Olav Bjarte, AU - Skadberg,Øyvind, AU - Øymar,Knut, Y1 - 2012/01/13/ PY - 2012/1/17/entrez PY - 2012/1/17/pubmed PY - 2012/4/27/medline SP - 215 EP - 20 JF - Archives of disease in childhood JO - Arch Dis Child VL - 97 IS - 3 N2 - OBJECTIVE: To evaluate the epidemiology of infectious meningitis in children in a Lyme borreliosis (LB) endemic area, and to study how clinical and laboratory characteristics may distinguish between different types of childhood meningitis. DESIGN: Retrospective, population based study. SETTING: A paediatric department serving all children (62 000) in a costal LB endemic region of southwestern Norway. PATIENTS: All children with cerebrospinal fluid pleocytosis aged 3 months to 14 years. MAIN OUTCOME MEASURES: Epidemiological, clinical and laboratory characteristics of different types of childhood meningitis. RESULTS: Infectious meningitis was diagnosed in 211 children (annual incidence 38/100 000). Lyme meningitis (LM) was identified in 142 children (67%), non-Lyme aseptic meningitis in 46 children (22%) and bacterial meningitis in 23 children (11%). Age, month of admission and clinical and laboratory characteristics differed between the groups. An aetiological agent was found in 89% of children. The positive predictive value for having LM if the child had facial nerve palsy or head and/or neck stiffness (meningism) as the only symptom was 97% for both variables. Symptoms of cerebral involvement or signs of systemic inflammation were rare in children with LM compared to children non-Lyme aseptic meningitis. CONCLUSION: LM was diagnosed in two-thirds of children with infectious meningitis in this LB endemic area. Distinct clinical characteristics distinguished the majority of children with LM from children with non-Lyme aseptic meningitis and bacterial meningitis. SN - 1468-2044 UR - https://www.unboundmedicine.com/medline/citation/22247243/Lyme_meningitis_the_major_cause_of_childhood_meningitis_in_an_endemic_area:_a_population_based_study_ L2 - https://adc.bmj.com/lookup/pmidlookup?view=long&pmid=22247243 DB - PRIME DP - Unbound Medicine ER -