04/12/2025
LYME DISEASE AND CHILDREN
Lyme disease can affect almost any part of the body, including the central and peripheral nervous system, heart, brain, muscles, joints, skin, and eyes.
Multiple symptoms with migratory joint pain that comes and goes is the hallmark of Lyme disease. Symptoms can appear soon after the infection or may not present until months or even years later.
In the early stage of the disease, patients typically experience flu-like symptoms including, fatigue, headaches, fevers, chills, body aches and pains, and gastrointestinal problems. There may also be objective signs of the disease present, such as the apperance of a erythema migrans (EM or bull’s-eye) rash. The EM rash is a clear indication of Lyme disease.
- There may be one single rash at the site of the known tick bite or multiple rashes, which indicates the Lyme bacteria is disseminating to other parts of the body;
- The area of the bite is usually not itchy and should not be confused with a spider bite;
- The rash usually appears within the first week but it can take up to 30 days.
The rash may appear on any area of the body, it is not always at the site of a known tick bite. It may also be hidden under the hair, on the scalp or in the perianal area. Studies have found that children are more likely to have a tick bite in the neck and head region.
Studies have found the EM rash is absent in more than 50% of Lyme disease cases.
Bottom line: Your child can have Lyme disease and not have the bull’s-eye rash.
Lyme disease, which can cause a wide range of physical, psychiatric and cognitive symptoms, can be particularly difficult to identify in children and adolescents. It’s difficult for young children to describe how they’re feeling, especially with a disease where symptoms are waxing and waning and changing over time. Parents may have difficulty recognizing symptoms when their child is young and there’s no medical baseline to compare with. And lastly, puberty and developmental stages may be blamed for sudden changes in the child’s behaviors and personality.
