Pediatric Lyme Disease

According to the American Association of Orthopaedic Surgeons, almost half of children with fluid in the knee in the Northeast United States are likely to have Lyme arthritis.

In a pediatric population, Lyme arthritis is probably the first diagnosis to be considered if you are in an endemic area. Connecticut has the highest rate of Lyme disease, but other areas of the United States are considered endemic, including New York State.

Lyme arthritis is on the rise, increasing almost 100 percent in the past 15 years, according to data from the Centers of Disease Control and Prevention (CDC). Children are nearly twice as likely to develop arthritis with Lyme disease than adults, and also to have it as the initial manifestation.

Distinguishing children who have Lyme arthritis from those who have septic arthritis can be a challenge in the emergency department, but doing so is essential because their treatment is so different. In a Lyme disease endemic area, a lot of children would come into the emergency department with a swollen joint, and the doctor would be forced to try to decide whether this is septic arthritis or Lyme arthritis. There is no rapid Lyme test that helps care providers at the point of initial presentation to decide if this is Lyme disease or not. This speaks to the fact that Lyme disease is so common that it really needs to be considered every time a child is evaluated for septic arthritis. The emphasis is that if you have a child with a mild injury and you have a significant knee effusion that is atraumatic or with minimal trauma, for those kids you really need to consider Lyme and test for Lyme disease.
 
Even though winter is here, Lyme disease is never gone. I would like to thank all who have supported the work of the Pediatric Lyme Disease Foundation by buying a Brittany Fellowship, Emerald Fellow, or the Joseph Michael Wuest Fellowship. I also would like to thank Circle K, Key Club, Builders Club and K-Kids for all their hard work fund raising for our cause.

If you know of someone with Lyme disease who needs financial help just give me or any board member a call. We need your help to continue helping these children. A big help would be if you bought a Fellowship for yourself or to honor someone. So remember, the main thing is to keep the main thing the main thing, and in Kiwanis, the main thing is helping children and that is what we do best.

Column Posted on Web Site February 1, 2015