Lyme Disease Lyme disease is becoming more widely recognized as a cause of joint symptoms in children. The diagnosis is established from a typical history and physical findings, along with a positive serologic test for Lyme disease. Lyme disease is transmitted by the deer tick Ixodes dammini, which carries the spirochete Borrelia burgdorferi. Patients of all ages and sex can be affected.
Most cases occur in summer and early fall.
The incubation period is 3-32 days. Symptoms can be divided into early and late stages, but any of the findings can occur any time, alone or with other symptoms. The initial manifestation is a skin lesion, erythema chronicum migrans, which originates at the site of the tick bite and spreads in an expanding circle, often with central clearing. The lesion is accompanied by such constitutional symptoms as malaise, fatigue, arthralgia, headache, and stiff neck. From this early stage, the disease may progress to a second stage in which symptoms and signs of meningitis, neuritis, or cardiac occur weeks to months after the tick bite, and are characterized by chronic neurologic symptoms and most commonly by pauciarticular arthritis.