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Borreliose im Kindes- und Jugendalter

Borreliosis in childhood and adolescence

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Zusammenfassung

Die Borreliose ist die häufigste durch Zecken übertragene Erkrankung. Kinder zwischen 5 und 14 Jahren weisen das größte Erkrankungsrisiko auf. Es handelt sich um eine entzündliche Multisystemerkrankung. Die frühe lokalisierte Form (Erythema migrans, EM) wird von frühen generalisierten Formen (z. B. Neuroborreliose, Lymphozytom) und späten Formen (z. B. Lyme-Arthritis) unterschieden. Es ist bekannt, dass die Borreliose zu häufig diagnostiziert wird. Einer der Hauptgründe hierfür ist die relativ hohe Seroprävalenz von Antikörpern gegen Borrelien bei gesunden Kindern und Jugendlichen. Ein EM ist eine rein klinische Diagnose und bedarf keiner weiteren serologischen Abklärung. Bei klinischen Symptomen einer Meningitis (mit oder ohne Fazialisparese) gibt es klare Empfehlungen zur Lumbalpunktion, während bei alleiniger peripherer Fazialisparese deutsche Fachgesellschaften eine Lumbalpunktion empfehlen und amerikanische Richtlinien dies nicht tun. Der vorliegende Beitrag fasst die aktuell gültigen Empfehlungen zur Behandlung der Borreliose zusammen; hierbei wurde der Schwerpunkt auf die europäischen Richtlinien gelegt.

Abstract

Borreliosis is the most common tick-borne disease with the highest risk of infection in children between 5 and 14 years old. It is defined as an inflammatory multisystemic disease. A distinction is made between the early localized form (erythema migrans), the early generalized form (e.g. neuroborreliosis and lymphocytoma) and later forms (e.g. Lyme arthritis). It is well-known that borreliosis is diagnosed too frequently and one of the main reasons is the relatively high prevalence of anti-Borrelia antibodies in healthy children and adolescents. Erythema migrans is a clinical diagnosis and no further serological investigations are necessary. A clear recommendation for lumbar puncture exists once clinical symptoms of meningitis (with or without facial palsy) occur. In cases with isolated peripheral facial palsy, German expert committees recommend a lumbar puncture but American guidelines do not. This article also summarizes the currently valid recommendations for treatment of borreliosis with an emphasis on the European guidelines.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. A.E. Sonnleitner, A. Trobisch, D.S. Klobassa und W. Zenz geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinische Abteilung für Allgemeine Pädiatrie, Medizinische Universität Graz, Auenbruggerplatz 34/2, 8036, Graz, Österreich

    A.E. Sonnleitner, A. Trobisch, D.S. Klobassa &  W. Zenz

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  1. A.E. Sonnleitner
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  2. A. Trobisch
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  3. D.S. Klobassa
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  4. W. Zenz
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Correspondence to W. Zenz.

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Sonnleitner, A., Trobisch, A., Klobassa, D. et al. Borreliose im Kindes- und Jugendalter. Monatsschr Kinderheilkd 163, 418–426 (2015). https://doi.org/10.1007/s00112-014-3251-1

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  • DOI: https://doi.org/10.1007/s00112-014-3251-1

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