Borrelial Lymphocytoma in Children.

Abstract

The aim of this study was to investigate demographic features, clinical characteristics, laboratory findings and posttreatment course of the disease in children with borrelial lymphocytoma (BL). Between 2008 and 2014, we prospectively studied 33 children younger than 15 years with untreated BL. Data on demographic and clinical features were collected by means of a questionnaire. Serological testing and Lyme borrelia blood cultures were performed. All patients were treated with recommended antibiotics. Patients were followed up at least 3 months after inclusion into the study. Twenty-two boys and 11 girls, aged 2-13 (median, 5.5) years, fulfilled the inclusion criteria. A tick bite at the site of BL was recalled by 30%. The median incubation period was 10.5 (range, 1-38) days. The median duration of BL before the initial examination was 10 (range, 0-270) days. In 88% of patients, BL was localized on ear lobe. The color/shape of BL was more often red (73%) and puffy (91%). Median size was 1.5 (range, 0.5-3) cm. The initial disease was mild in 82%. Associated symptoms were reported in 36% of patients. Concomitant solitary erythema migrans and meningitis were detected in 9% and 3% of patients, respectively. Serum borrelial antibodies were present in 40% of patients. In 7%, Borrelia afzelii was isolated from blood. Posttreatment course of the disease revealed the median duration of BL and systemic symptoms for 16 (range, 2-46) and 15 (range, 3-40) days, respectively. BL in children, treated with recommended antibiotics, is a mild disease with a good prognosis.