|
Home
|
|
Symptoms
|
|
Lyme Chat Group
|
|
Diagnosis
|
|
Treatment
|
|
World-wide Support Finder
|
|
Books/Video
|
|
RESEARCH
|
|
Lymelinks
|
|
Contact
|
|
Pets & Lyme
|
|
DONATIONS
|
|
Drug Info
|
|
Medical Dictionary
|
|
Board of Directors
|
Click on the graphic to vote for this
site as a Starting Point Hot Site.
|
|
|
No Warranties or Representations
Lyme Disease symptoms vary from person to person. (lymes disease lyme's disease lime disease limes disease)
The data and information presented in this web site are presented in good faith and believed to be accurate regarding Lyme disease (commonly misspelled lymes disease lyme's disease lime disease limes disease) and other related diseases. Any and all liability for the content or any omissions including any inaccuracies, errors, or misstatements in such data or information is expressly disclaimed. The web site is compiled for the sole purpose of informing community members of resources and information pertaining to Lyme Borreliosis Disease and its coinfections. Lyme disease symptoms may vary from person to person.
The Canadian Lyme Disease Foundation, Directors and members are not liable for any direct or indirect damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action arising out of or in connection with the use or performance of information available from this website.
Consult a qualified Lyme ( Borreliosis ) Disease literate doctor for medical advice if Lyme Disease is suspect to discuss your Lymes Disease Symptoms.
|
|
http://pediatrics.aappublications.org/cgi/content/abstract/123/5/e835
Published online April 27, 2009
PEDIATRICS Vol. 123 No. 5 May 2009, pp. e835-e841
(doi:10.1542/peds.2008-3058)
Lyme Carditis in Children: Presentation, Predictive Factors, and
Clinical Course
John M. Costello, MD, MPHa,(b,c); Mark E. Alexander, MDb,(c,d); Karla M.
Greco, MDa,(b,c); Antonio R. Perez-Atayde, MD (e,f); and Peter C. Laussen,
MBBSa,(b,c,g)
a Divisions of Cardiac Intensive Care
d Electrophysiology
b Departments of Cardiology
e Pathology, Children's Hospital Boston, Boston, Massachusetts
c Departments of Pediatrics
f Pathology
g Anesthesia, Harvard Medical School, Boston, Massachusetts
OBJECTIVES. We sought to identify predictive factors for Lyme carditis
in children and to characterize the clinical course of these patients.
METHODS. We reviewed all cases of early disseminated Lyme disease
presenting to our institution from January 1994 through July 2008, and
summarized the presentation and course of those patients with carditis.
A case-control study was used to identify predictive factors for
carditis. Controls were patients with early disseminated Lyme disease
without carditis.
RESULTS. Of 207 children with early disseminated Lyme disease, 33 (16%)
had carditis, 14 (42%) of whom had advanced heart block, including 9
(27%) with complete heart block. The median time to recovery of sinus
rhythm in these 14 patients was 3 days (range: 1-7 days), and none
required a permanent pacemaker. Four (12%) of 33 patients with carditis
had depressed ventricular systolic function, 3 (9%) of whom required
mechanical ventilation, temporary pacing, and inotropic support.
Complete resolution of rhythm disturbances and myocardial dysfunction
occurred in 24 (89%) of 27 patients for whom follow-up data were
available. Most patients with carditis also had other systemic Lyme
involvement. By using multivariate logistic regression analysis, we
found that children >10 years of age, those with arthralgias, and those
with cardiopulmonary symptoms were more likely to have carditis.
CONCLUSIONS. The spectrum of presentation for children with Lyme
carditis is broad, ranging from asymptomatic, first-degree heart block
to fulminant myocarditis. Variable degrees of heart block are the most
common manifestation and occasionally require temporary pacing.
Transient myocardial dysfunction, although less common, can be
life-threatening. Advanced heart block resolves within 1 week in most
cases. In children with early disseminated Lyme disease, older age,
arthralgias, and cardiopulmonary symptoms independently predict the
presence of carditis.
Key Words: Lyme disease . myocarditis . carditis . heart block . children
Abbreviations: AVB-atrioventricular block . ECMO-extracorporeal membrane
oxygenation . aOR-adjusted odds ratio . CI-confidence interval
Accepted Jan 30, 2009
TOP
|
| |
|
