Borrelial Lymphocytoma in Children

Abstract

Background: 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).

Methods: 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.

Results: 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.

Conclusions: BL in children, treated with recommended antibiotics, is a mild disease with a good prognosis.