nonresponders described w all antibiotic regimens -standard therapy not yet established.
- From: "CaliforniaLyme" <CaliforniaLyme@xxxxxx>
- Date: 19 Apr 2005 10:51:58 -0700
1: J Rheumatol. 2000 Aug;27(8):2025-30. Related Articles, Links
Comment in:
J Rheumatol. 2000 Aug;27(8):1836-8.
Lyme arthritis in children and adolescents: outcome 12 months after
initiation of antibiotic therapy.
Bentas W, Karch H, Huppertz HI.
Children's Hospital and Institute of Hygiene and Microbiology,
University of Wurzburg, Germany.
OBJECTIVE: Lyme arthritis in children and adolescents due to infection
with Borrelia burgdorferi responds well to intravenous and oral
antibiotics, but nonresponders have been described with all antibiotic
regimens tested and a standard therapy has not yet been established. We
examined causes of the failure of antibiotic treatment in the presence
of persistent organisms and autoimmune mechanisms. METHODS: A
prospective multicenter study was carried out in 55 children and
adolescents with Lyme arthritis. RESULTS: There were significant
differences between younger and older patients with pediatric Lyme
arthritis. Younger patients were more likely to have fever at the onset
of arthritis and to have acute or episodic arthritis. Older patients
were more likely to have chronic arthritis, higher levels of IgG
antibodies to B. burgdorferi (by ELISA and immunoblot), and a longer
interval between antibiotic treatment and the disappearance of
arthritis. Of 51 patients followed for at least 12 months after
initiation of antibiotic treatment, 24% retained manifestations of the
disease including arthritis (8 patients) and arthralgias (4 patients).
These patients were predominantly female (9/12) and were significantly
older than patients without residual symptoms. Patients who had
received intraarticular steroids prior to antibiotic treatment required
significantly more courses of antibiotic treatment and the time
required for disappearance of the arthritis was longer. CONCLUSION:
Pediatric Lyme arthritis is more benign in younger children. Lyme
arthritis should be excluded as a possible cause of arthritis prior to
the administration of intraarticular steroids.
Publication Types:
Clinical Trial
Multicenter Study
PMID: 10955347 [PubMed - indexed for MEDLINE]
.
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