Diastolic Heart Murmur, Nocturnal Back Pain, and Lumbar Rigidity in a 7-Year Girl: An Unusual Manifestation of Lyme Disease in Childhood
A 7-year-old girl presented with nocturnal pain in her back and legs. The physical examination revealed a loud opening sound of the mitral valve and lumbar rigidity. With the exception of significantly increased anti-nuclear antibody (ANA) levels, the immunological findings did not show any other ab...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Case Reports in Pediatrics |
| Online Access: | http://dx.doi.org/10.1155/2012/976961 |
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| author | Genn Kameda Silvia Vieker Johannes Hartmann Tim Niehues Alfred Längler |
| author_facet | Genn Kameda Silvia Vieker Johannes Hartmann Tim Niehues Alfred Längler |
| author_sort | Genn Kameda |
| collection | DOAJ |
| description | A 7-year-old girl presented with nocturnal pain in her back and legs. The physical examination revealed a loud opening sound of the mitral valve and lumbar rigidity. With the exception of significantly increased anti-nuclear antibody (ANA) levels, the immunological findings did not show any other abnormal parameters, also spinal magnetic resonance imaging (MRI) and ultrasound examination of the abdomen and pelvis yield no pathological findings. The lumbar puncture showed a lymphocytic pleocytosis as well as an intrathecal synthesis of Borrelia-specific antibodies. Echocardiography showed a thickened mitral valve with mild regurgitation. No other signs of florid endocarditis or myocarditis could be detected. Due to these findings, the diagnosis Lyme neuroborreliosis was made and an intravenous antibiotic therapy was given. The clinical symptoms subsided. Six months later, she had an almost normal mitral valve with only trivial mitral insufficiency. The association between the lumbar rigidity and the thickened mitral valve remains unclear. The case of our patient with nocturnal back and leg pain may be considered a rare case of Lyme neuroborreliosis with meningoradiculitis in children, and to our knowledge these symptoms together with cardiac involvement, such as a significantly thickened mitral valve, have not yet been described in the literature. |
| format | Article |
| id | doaj-art-083bbbf75dd44a158a11c0b9531eaf75 |
| institution | Kabale University |
| issn | 2090-6803 2090-6811 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pediatrics |
| spelling | doaj-art-083bbbf75dd44a158a11c0b9531eaf752025-08-20T03:55:32ZengWileyCase Reports in Pediatrics2090-68032090-68112012-01-01201210.1155/2012/976961976961Diastolic Heart Murmur, Nocturnal Back Pain, and Lumbar Rigidity in a 7-Year Girl: An Unusual Manifestation of Lyme Disease in ChildhoodGenn Kameda0Silvia Vieker1Johannes Hartmann2Tim Niehues3Alfred Längler4Department for Child and Adolescent Health, Gemeinschaftskrankenhaus, Gerhard-Kienle Weg 4, 58313 Herdecke, GermanyDepartment for Child and Adolescent Health, Gemeinschaftskrankenhaus, Gerhard-Kienle Weg 4, 58313 Herdecke, GermanyConsultant for Pediatric Cardiology, Gemeinschaftskrankenhaus, Gerhard-Kienle Weg 4, 58313 Herdecke, GermanyCenter for Child and Adolescent Health, Helios Klinikum, Lutherplatz 40, 47805 Krefeld, GermanyUniversity of Witten/Herdecke, Faculty of Health, Center for integrative Medicine, Alfred-Herrhausenstr. 50, 58448 Witten, GermanyA 7-year-old girl presented with nocturnal pain in her back and legs. The physical examination revealed a loud opening sound of the mitral valve and lumbar rigidity. With the exception of significantly increased anti-nuclear antibody (ANA) levels, the immunological findings did not show any other abnormal parameters, also spinal magnetic resonance imaging (MRI) and ultrasound examination of the abdomen and pelvis yield no pathological findings. The lumbar puncture showed a lymphocytic pleocytosis as well as an intrathecal synthesis of Borrelia-specific antibodies. Echocardiography showed a thickened mitral valve with mild regurgitation. No other signs of florid endocarditis or myocarditis could be detected. Due to these findings, the diagnosis Lyme neuroborreliosis was made and an intravenous antibiotic therapy was given. The clinical symptoms subsided. Six months later, she had an almost normal mitral valve with only trivial mitral insufficiency. The association between the lumbar rigidity and the thickened mitral valve remains unclear. The case of our patient with nocturnal back and leg pain may be considered a rare case of Lyme neuroborreliosis with meningoradiculitis in children, and to our knowledge these symptoms together with cardiac involvement, such as a significantly thickened mitral valve, have not yet been described in the literature.http://dx.doi.org/10.1155/2012/976961 |
| spellingShingle | Genn Kameda Silvia Vieker Johannes Hartmann Tim Niehues Alfred Längler Diastolic Heart Murmur, Nocturnal Back Pain, and Lumbar Rigidity in a 7-Year Girl: An Unusual Manifestation of Lyme Disease in Childhood Case Reports in Pediatrics |
| title | Diastolic Heart Murmur, Nocturnal Back Pain, and Lumbar Rigidity in a 7-Year Girl: An Unusual Manifestation of Lyme Disease in Childhood |
| title_full | Diastolic Heart Murmur, Nocturnal Back Pain, and Lumbar Rigidity in a 7-Year Girl: An Unusual Manifestation of Lyme Disease in Childhood |
| title_fullStr | Diastolic Heart Murmur, Nocturnal Back Pain, and Lumbar Rigidity in a 7-Year Girl: An Unusual Manifestation of Lyme Disease in Childhood |
| title_full_unstemmed | Diastolic Heart Murmur, Nocturnal Back Pain, and Lumbar Rigidity in a 7-Year Girl: An Unusual Manifestation of Lyme Disease in Childhood |
| title_short | Diastolic Heart Murmur, Nocturnal Back Pain, and Lumbar Rigidity in a 7-Year Girl: An Unusual Manifestation of Lyme Disease in Childhood |
| title_sort | diastolic heart murmur nocturnal back pain and lumbar rigidity in a 7 year girl an unusual manifestation of lyme disease in childhood |
| url | http://dx.doi.org/10.1155/2012/976961 |
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