Pediatric Treatment for Lyme Disease

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Treatment for Lyme disease must be handled a very specific way when children are involved. Learn about pediatric treatment for Lyme disease with help from a practicing pediatrician in this free video clip.

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Video Transcript

Hi, I'm Dr. David Hill, and today we're going to talk about pediatric treatment for Lyme Disease. Now this is a really serious topic and it causes a lot of concern. Lyme disease is compared to some other conditions a little bit less common, but common enough that we always have to keep it in mind, especially when children have been in areas with lots of ticks. Now, one thing to remember about Lyme Disease is just because nobody remembers a tick being on a child, that doesn't mean that he or she has not been infected. In fact, about 80 percent of kids who ultimately are infected with a tick-borne illness have no recollection of ever having been bitten by a tick. So, having been in a place where there might be ticks is enough of a risk factor. When do we suspect Lyme Disease? The most classic presentation of Lyme Disease is what we call Erythema Migrans. This may start as just a little red bump, and then it grows outward with a red ring. It may clear in the middle. There may even be some death of the tissue in the center of the ring. This is described as a target lesion, because it's short of shaped and looks a little bit like a target. Now, if the child has just developed one of these lesions, there's only one of them, he or she may have some fever, some headaches, some joint pain, some fatigue. We call this early localized Lyme Disease because it's just right there around the bite for right now. That is treated with antibiotics for between two and three weeks, 14 to 21 days. The best antibiotic to use is probably Doxycycline. However, in children under age eight, Doxycycline can cause staining of the teeth, so we do have some alternatives. Amoxicillin is one alternative. Cefuroxime is another. And in some cases, if children can't take medicine by mouth for some reason, we can give injections into the muscle or into the veins. There's a medicine called Ceftriaxone. Now, as Lyme progresses, it comes to what we call Early Disseminated Disease. There might be a second or third or fourth target lesion that looks very much like the first one. The child might be getting some effect of the nerves, the nerve to the face is commonly affected, and a child may not be able to move one side or the other of the face. There can also be some further issues with the joints, even the heart. There can be some brain issues that occur. As Lyme is getting worse, we treat for longer. So, with Early Disseminated Disease, we treat for between three and four weeks pretty much with the same antibiotics we discussed for Early Localized Disease. Now, there are some rather nasty late term effects that Lyme Disease can have, and we need to treat those very aggressively when they occur. People who did not get effectively treated at the early part of the illness may go on to have chronic joint pains and arthritis. This is Late Disseminated Lyme Disease, and that has to be treated for between three and four weeks with some of the medicines that we already mentioned, although it's a shorter list. At this point, you're more likely to use Penicillin injections or Ceftriaxone injections. Lyme can also infect the heart, in which case you're going to want to treat for a prolonged period of time, such as three to four weeks. If there is a brain infection, a Meningitis with Lyme Disease, you're also looking at three to four weeks of treatment in many cases. Lyme is really serious. So, if you suspect that your child may have Lyme Disease, absolutely take him or her to see a doctor, get an appropriate evaluation. A lot of times, we're not absolutely sure whether the child has Lyme or not. It takes a long time to get the test back when we're looking for it, so in those cases we'll often start treatment immediately, and then figure out later on whether we were right or not that the child had Lyme. Talking about pediatric treatment of Lyme Disease, I'm Dr. David Hill.


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