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Lyme disease: Clinical manifestations in children

Eugene D Shapiro, MD, FAAP
Section Editor
Sheldon L Kaplan, MD
Deputy Editor
Mary M Torchia, MD


Lyme disease is a tick-borne illness primarily caused by a number of pathogenic genomospecies of the spirochete Borrelia burgdorferi sensu lato ("in the broad sense") [1]. The nomenclature of Borrelia that cause human infections is in transition and the genus name may be represented as either Borrelia or Borreliella. (See "Microbiology of Lyme disease".)

Lyme disease has a broad spectrum of clinical manifestations which vary, in part, due to differences in the infecting genomospecies. B. burgdorferi sensu stricto ("in the narrow sense") is the primary cause of Lyme disease in the United States. Another genomospecies, Borrelia mayonii, causes Lyme disease in the northern Midwestern states, with clinical manifestations and serologic changes similar to those of disease caused by B. burgdorferi [2]. B. burgdorferi sensu stricto, Borrelia afzelii, and Borrelia garinii and a number of other genomospecies may cause disease in Europe, and B. afzelii and B. garinii have been identified in Asia.

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 [3-5]:

Early localized disease

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Literature review current through: Nov 2017. | This topic last updated: Oct 23, 2017.
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