Arnez M, Pleterski-Rigler D, Luznik-Bufon T, Ruzic-Sabljić E, Strle F
Dept. of Infectious Diseases, University Medical Centre Ljubljana, Japljeva 2, SLO-1525 Ljubljana, Slovenia.
Infection. 2003 Dec;31(6):404-9. doi: 10.1007/s15010-003-4007-3.
Data on European children with erythema migrans (EM) are limited.
553 patients, 333 with solitary and 220 with multiple EM, diagnosed between 1996 and 2000, were included in the prospective study. Demographic, clinical and laboratory data including borrelial serum immunofluorescence assay antibody titers and Borrelia burgdorferi sensu lato blood culture results were obtained; findings in solitary and multiple EM were compared.
Comparison revealed that children with multiple EM were younger (4.5 vs 6.5 years; p = 0.0000), less often reported a tick bite at the site of later skin lesion (25% vs 46%; p = 0.0000), had a longer incubation period (22 vs 13 days; p = 0.0028), more frequently presented with a ringlike lesion (99% vs 86%; p = 0.0000), less often reported associated local (15% vs 41%; p = 0.0000) but not systemic symptoms (28% vs 26%, p = 0.6913), more frequently had abnormal findings on physical examination (35% vs 26%; p = 0.0264), and a higher frequency of laboratory abnormalities including the presence of borrelial serum antibodies as well as B. burgdorferi sensu lato isolated from blood (12% vs 6%; p = 0.0267); younger age and male sex were identified as risk factors for the isolation of Borrelia. 40/44 isolates were Borrelia afzelii.
Analysis of a large group of European children with solitary and multiple EM revealed several demographic, clinical and laboratory differences between the two groups.
关于欧洲患有游走性红斑（EM）儿童的数据有限。
553例患者纳入了这项前瞻性研究，其中1996年至2000年间诊断为单发EM的有333例，多发EM的有220例。收集了人口统计学、临床和实验室数据，包括疏螺旋体血清免疫荧光测定抗体滴度和伯氏疏螺旋体狭义血培养结果；比较了单发和多发EM的研究结果。
比较发现，多发EM儿童年龄更小（4.5岁对6.5岁；p = 0.0000），较少报告在后来出现皮肤病变的部位被蜱叮咬（25%对46%；p = 0.0000），潜伏期更长（22天对13天；p = 0.0028），更常出现环状病变（99%对86%；p = 0.0000），较少报告伴有局部症状（15%对41%；p = 0.0000）但全身症状报告频率无差异（28%对26%，p = 0.6913），体格检查异常发现更频繁（35%对26%；p = 0.0264），实验室异常频率更高，包括存在疏螺旋体血清抗体以及从血液中分离出伯氏疏螺旋体狭义菌株（12%对6%；p = 0.0267）；年龄较小和男性被确定为分离出疏螺旋体的危险因素。44株分离菌株中有40株为阿氏疏螺旋体。
对一大组欧洲单发和多发EM儿童的分析揭示了两组之间在人口统计学、临床和实验室方面的若干差异。
