when asked if they wish they felt better they respond, “yes.” The common Lyme symptoms should be reviewed: Does the child have new onset fatigue or joint pain? Does the child have swollen joints? Has the child had a rash? A red rash with central clearing (bull’s
eye), called erythema migrans (EM), is di- agnostic of Lyme disease. Studies show that 40-69% of people have the classic EM rash; however, physicians report that this rate may be as low as 10%. This rash may not occur at the bite site. Patients may present with multiple EM rashes or other types of rashes. Fifty to seventy-five per- cent of those infected with Lyme disease do not remember having had a tick bite. The bacteria that causes Lyme disease seems to have a preference for causing problems in the joints, the brain, the gas- trointestinal/digestive (GI) system and the urinary tract. In children, symptoms of- ten include acute changes in personality (especially becoming withdrawn or have poor social skills), hyperactivity, rage, ir- ritability, digestive difficulties, headaches, and anxiety. Children may also have prob- lems with speech and motor skills and perform poorly in school. It is important to note that the ticks that carry Lyme disease can also carry other infections that can cause changes in behavior.
Many children develop sleep prob-
lems, including nightmares. New onset bedwetting may also develop. Daytime urinary frequency is often seen. Some children present with odd skin sensations and others just have discomfort when be- ing touched. If a child is favoring one limb over the other for an unknown reason, Lyme disease should be considered as a possible cause. Children can have dif- ficulty with balance. They can also have swollen large and small joints; evaluation of all the joints, including the spine is a necessary part of the physical examination to determine if the joints are involved. Children and adolescents often exhib-
it Lyme disease symptoms in the GI tract. These include abominal pain, heartburn, nausea, vomiting, diarrhea and blood in the stool. Gastrointestinal Lyme disease may mimic colitis or Crohn’s disease. Small intestinal bacteria overgrowth may be present. Co-infections, other illnesses transmitted by ticks, including babesia, bartonella, mycoplasma and H. pylori, have been found in the GI tract. The nervous system (brain, spinal cord
and nerves) is a common target of Lyme disease. Children may present with symp- toms such as fatigue, malaise, irritability, headache, photophobia (light sensitivity) and phonophobia (sound sensitivity). Dif-
16
June 2010
www.naturalnutmeg.com
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