Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA.
Rutgers Robert Wood Johnson School of Biomedical Sciences, Piscataway, NJ, USA.
J Child Neurol. 2024 Aug;39(9-10):310-316. doi: 10.1177/08830738241272069. Epub 2024 Aug 28.
This retrospective chart review examined children with documented Lyme disease serology in New Jersey aged <21 years presenting with facial nerve palsy. The presence of symptoms including tick bite, fever, headache, and arthritis was recorded. Data were categorized based on demographic factors, and multivariate regression was employed. We enrolled 122 children, 54% female (mean age of 11.4 ± 5.1 years); 22.1% had Lyme disease. Fever was a significant predictor of Lyme disease ( = .01), confirmed by multivariate regression (odds ratio [OR] = 16.11, 95% confidence interval [CI] = 2.04, 366.14), as was male gender ( = .01, OR = 3.68, 95% CI = 1.21, 12.89). This association held especially true in Lyme-endemic regions (prevalence ≥ 0.35). The combination of headache with fever was also significantly predictive ( = .01). We found no significant predictive value in the remaining symptoms. These findings suggest that clinical predictors may be useful in diagnosing Lyme disease and initiating early empiric treatment.
这项回顾性图表研究检查了新泽西州年龄小于 21 岁、有记录的莱姆病血清学表现为面神经麻痹的儿童。记录了包括蜱虫叮咬、发热、头痛和关节炎在内的症状。根据人口统计学因素对数据进行了分类，并采用多元回归分析。我们共纳入了 122 名儿童，其中 54%为女性（平均年龄为 11.4 ± 5.1 岁）；22.1%患有莱姆病。发热是莱姆病的一个显著预测因素（ = .01），这一结果在多元回归分析中得到了证实（优势比 [OR] = 16.11，95%置信区间 [CI] = 2.04，366.14），男性（ = .01，OR = 3.68，95% CI = 1.21，12.89）也是如此。这种关联在莱姆病流行地区（流行率 ≥ 0.35）尤其明显。头痛伴发热也具有显著的预测价值（ = .01）。我们在其他症状中没有发现显著的预测价值。这些发现表明，临床预测因素可能有助于诊断莱姆病并启动早期经验性治疗。
