Banadyha Nataliya, Rogalskyy Igor, Komorovsky Roman
Department of Pediatrics, Faculty of Postgraduate Education, Ivan Horbachevsky Ternopil National Medical University, Ternopil, Ukraine.
Main Administration, State Service of Ukraine for Food Safety and Consumers Protection, Ternopil, Ukraine.
Infect Drug Resist. 2024 Oct 10;17:4343-4348. doi: 10.2147/IDR.S489845. eCollection 2024.
Herein we report a case of Lyme borreliosis in a pediatric patient, highlighting the diagnostic challenges associated with this condition. An 11-year-old girl was admitted with high fever, headaches, abdominal pain, and a progressing rash. Initial symptoms included small rashes that vanished with antihistamine treatment, but maculopapular rashes later emerged on the trunk and limbs, prompting further investigation. Differential diagnosis included toxic erythema, Stevens-Johnson syndrome, and Lyme borreliosis. Despite no reported tick bite and initial doubt due to the season, Lyme borreliosis was confirmed by serologic testing, diagnosing the patient with early disseminated Lyme disease. The diagnostic complexity was increased by the rash's atypical presentation - large, homogeneous papular rashes. This case emphasizes the necessity for physicians to adeptly gather detailed histories and employ thorough, up-to-date diagnostic methods. Effective correlation of clinical findings with laboratory results and ongoing patient observation proved critical for an accurate diagnosis. This report underscores the importance of recognizing atypical presentations of Lyme borreliosis in children and the need for careful differential diagnosis.
在此，我们报告一例儿科莱姆病病例，强调了与该病症相关的诊断挑战。一名11岁女孩因高烧、头痛、腹痛和逐渐发展的皮疹入院。初始症状包括小皮疹，经抗组胺治疗后消失，但随后躯干和四肢出现斑丘疹，促使进一步检查。鉴别诊断包括中毒性红斑、史蒂文斯 - 约翰逊综合征和莱姆病。尽管没有报告蜱虫叮咬且由于季节原因最初存在疑问，但通过血清学检测确诊为莱姆病，诊断该患者为早期播散性莱姆病。皮疹的非典型表现——大的、均匀的丘疹性皮疹增加了诊断的复杂性。该病例强调了医生熟练收集详细病史并采用全面、最新诊断方法的必要性。临床发现与实验室结果的有效关联以及对患者的持续观察对于准确诊断至关重要。本报告强调了认识儿童莱姆病非典型表现的重要性以及仔细进行鉴别诊断的必要性。
