Borrelial Lymphocytoma in a Child. Clinical Case

Lyme borreliosis is a multisystem infectious disease caused by bacteria of the Borrelia burgdorferi sensu lato complex.The course of the disease is characterized by three stages: early localized, early disseminated and late disseminated. One of the rare forms of the early disseminated stage of Lyme disease in children is lymphocytoma.We present a clinical case of borrelial lymphocytoma caused by a combination of three types of Borrelia (Borrelia afzelii, Borrelia burgdorferi, Borrelia garinii) in a 6-year-old girl. The disease manifested as multiple migratory erythema on the child's face, mistaken for allergic dermatitis. According to the parents, the child had no history of tick bites. The diagnosis was confirmed by the ELISA method and immunoblot analysis. The patient was prescribed a 21-day course of doxycycline at 50 mg twice daily. Three weeks after the initiation of antibiotic therapy, complete regression of the lymphocytoma was observed. The purpose of the study is to draw the attention of doctors of various specialties to rare forms of Lyme borreliosis against the background of the absence of a verified fact of tick bite.Material and methods. Confirmation of the diagnosis by ELISA and immunoblot analysis.Research results. A clinical case of borrelial lymphocytoma caused by a combination of three Borrelia species (Borrelia afzelii, Borrelia burgdorferi, Borrelia garinii) in a 6-year-old girl is presented. The disease manifested as multiple migratory erythema in the area of the child's face, which was mistaken for allergic dermatitis. According to the parents, the child had no history of a tick bite. The diagnosis was confirmed by ELISA and immunoblot analysis. The patient was prescribed doxycycline treatment for 21 days at 50 mg twice a day. Three weeks after the start of antibiotic therapy, a complete regression of the lymphocytoma was observed.Conclusions. Doctors of various specialties have difficulties in diagnosing Lyme disease in its various stages, especially in children with a heavy allergic history. With the presented clinical case, we want to emphasize the importance of early and timely diagnosis of Lyme borreliosis, in particular, in the absence of an episode of tick bite in the anamnesis.