Demographic features, clinical characteristics and laboratory findings in children with multiple erythema migrans in Slovenia

Objective: To identify demographic, clinical and laboratory characteristics of children with multiple erythema migrans (EM) in Slovenia. Methods: We prospectively studied patients aged 15 years and less, examined at our department for multiple EM in 1996 and 1997. Demographic and clinic al data were collected by means of a questionnaire. In addition, basic haem atological and biochemical investigations, serologic testing, and Borrelia cerebrospinal fluid and blood cultures were performed. Results: Ninety-five children (44 girls, 55 boys) aged 1 to 13.5 (median, 4 .5) years fulfilled the inclusion criteria. A tick bite was recalled by 23% . The incubation period was 10.5 (range, 1 to 150) days, the duration of sk in lesions before the initial examination 4 (range, 1 to 54) days, and the median number of skin lesions, 4.5 (range, 2 to 35). The initial disease wa s mild in 81% of patients. Local and systemic symptoms were reported by 11% and 30% of children, respectively. Clinical signs accompanying EM lesions were found in 42%. Cerebrospinal pleocytosis (predominantly lymphocytic) wa s seen in 18% of patients; none of them had frank clinical evidence of cent ral nervous system involvement. Serum IgM and IgG antibodies were detected in 28% and 22% of children, respectively. In 3/79 (4%) patients, Borreliae were isolated from the blood and in 2/83 (2%) from the cerebrospinal fluid. In 2/81 (2%) children, borrelial IgG intrathecal antibody production was d emonstrated. Conclusions: Multiple EM in Slovene children is a mild disease. However, so me patients had an associated, usually asymptomatic, infection of the centr al nervous system.