Lyme disease is a tick-borne illness primarily caused by a number of pathogenic genomospecies of the spirochete Borrelia burgdorferi sensu lato . B. burgdorferi sensu stricto is the sole cause of the disease in the United States. B. burgdorferi sensu stricto, B. afzelii, and B. garinii and a number of other genomospecies may cause disease in Europe and B. afzelii, and B. garinii have been identified in Asia. Lyme disease has a broad spectrum of clinical manifestations. The clinical manifestations vary, in part, due to differences in the infecting genomospecies.
The clinical manifestations of Lyme disease in children will be reviewed here. The clinical manifestations of Lyme disease in adults and the microbiology, epidemiology, treatment, and prevention of Lyme disease are discussed separately. (See "Epidemiology of Lyme disease" and "Clinical manifestations of Lyme disease in adults" and "Diagnosis of Lyme disease" and "Treatment of Lyme disease" and "Prevention of Lyme disease".)
The clinical manifestations of Lyme disease depend on the stage of the illness [2-4]:
- Early localized disease
- Early disseminated disease
- Late disease
The clinical manifestations of Lyme disease in children were described in a community-based prospective study of 201 Connecticut children with Lyme disease who were enrolled between April 1992 and November 1993 . The median age was seven years (range 1 to 21 years). The presenting manifestations were as follows: