The long-term outcome of 63 children with erythema migrans, treated early with antibiotics at the Wildwood Pediatrics Clinic, Essex, Connecticut, was determined by telephone interview 1 to 6 years after the initial episode of Lyme disease. Penicillin V (60% of patients), amoxicillin (25%), tetracycline (10%), or doxycycline (5%), had been given orally for 10 to 30 days. None of the patients had carditis, arthritis, or neurologic complications attributable to Lyme disease. A recurrence of erythema migrans was reported in 7 (11%). [1]
COMMENT. Treatment of Lyme disease at an early stage appears to protect from serious neurologic and other sequelae.
A prospective study of the clinical and epidemiological features of 187 consecutive patients with neuroborreliosis recognized in Denmark over a 6-year period showed that 61% had Bannwarth’s syndrome with paresis, a painful lymphocytic meningoradiculitis, during the second stage of the disease. CNS involvement in the early stages was rare; 4% had myelitis and 1 patient had acute encephalitis. The final morbidity after a 3 year median follow-up was low; disabling sequelae were reported in 9 (5%) patients [2]. Measurement of intrathecal anti-Borrelia burgdorferi antibody is a reliable indicator of CNS infection. [3]