Bannwarth Syndrome – Rare Lyme Disease Manifestation in Children

  • Sandis Kovaļovs (Speaker)
  • Emīlija Reimane (Co-author)
  • Guntis Rozentāls (Co-author)

Activity: Talk or presentation types › Poster presentation

Description

Lyme disease is a tick-borne illness primarily caused by B.Burgdorferi. In Europe, neuroborreliosis occurs in up to 15% of infected patients. Bannwarth syndrome is a clinical manifestation of neuroborreliosis with painful radiculopathy, facial nerve palsy and lymphocytic pleocytosis in cerebrospinal fluid(CSF). It is very rare among children with only a few described cases published in literature. A 12 years old male patient was admitted to the hospital with lower back pain with radiation to the right groin. Symptomatic treatment with analgesics was administered for three days, after clinical improvement, the patient was discharged from hospital. After 12 days, facial asymmetry appeared and the patient returned back to the hospital. On examination, the patient had subfebrile body temperature, facial nerve palsy(FNP) on the right side, weakened deep tendon reflexes in both legs and lower back pain with radiation to L1-L2 spinal root distribution on the right side. CSF analysis showed pleocytosis(376 cells/uL) with lymphocytic predominance and protein level of 3,1g/L. B.burgdorferi IgG antibodies(Ab) were found in CSF and serum, but B.burgdorferi DNA was detected in CSF. Ab index of CSF:serum was not performed due to lack of CSF sample. Magnetic resonance imaging showed contrast enhancement of the right facial nerve and polyradiculoneuritis at the level of cauda equina. Treatment with intravenous ceftriaxone was initiated. On the second day of treatment, FNP appeared on the left side. After 21 days of treatment, gradual muscle strength improvement in face was seen, lower back pain was absent and body temperature was normal. We presented a pediatric patient with Bannwarth syndrome. Case showed that rather nonspecific onset of symptoms led to delayed diagnostics. It may be possible that because of that Bannwarth syndrome is underdiagnosed among children worldwide. In our case, even after delayed diagnostics, appropriate treatment led to a favorable outcome.. .. .. .
Period29 Mar 2023
Event titleRSU International Research Conference 2023: Knowledge for Use in Practice
Event typeConference
OrganiserRīga Stradiņš University
LocationRiga, LatviaShow on map
Degree of RecognitionInternational

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