Stories about: pediatrics

Lyme disease: What to know, how to treat and when to refer

Image of the deer tick, which transmits Lyme disease
Lyme disease is transmitted by the deer tick.

We asked pediatric infectious disease specialist Catherine Lachenauer, MD, of the Boston Children’s Hospital Division of Infectious Diseases, to answer some frequently-asked questions about Lyme disease in children. Here’s what she had to say:

How common is Lyme disease and what are some early symptoms?

Lyme disease is the most common tick-borne infection in the US. The number of reported cases has been rising over the years.

One of the best recognized and earliest symptoms of Lyme disease is the erythema migrans, or EM rash, that may appear within the first month (usually within the first two weeks) following the tick bite.  The EM rash occurs at the site of the bite, typically as a circular red rash that enlarges over the course of several days.  Often, there is clearing as the rash enlarges such that it appears as a “bullseye,” although it may also be a solid, or confluent, rash.  Patients may also have non-specific, flu-like symptoms including fever, headache, joint aches and fatigue, as early symptoms of Lyme disease.

A tick needs to be attached for at least 48 hours to transmit the Lyme-causing bacteria

What are some later-stage symptoms of Lyme disease in children?

Most symptoms of Lyme disease occur in three stages: early localized, early disseminated and late-stage disease.

In the early localized stage, usually within one to two weeks following the tick bite, a single EM rash may appear. Patients who are not diagnosed and treated with antibiotics in the early localized stage, they may go on to have symptoms of early disseminated disease. …Read More

Seeing esotropia? Take fast action: Q&A with ophthalmologist

Diagram showing esotropia, aka an inward-turning crossed eye
Esotropia is the term used to describe an inward-turning crossed eye.

 

According to the American Academy of Ophthalmology, about 4 percent of children have some form of strabismus (crossed eye). In infants, the most common type of crossed eye is known as esotropia, which is when the eye or eyes turn inward.

Although it can sometimes be as simple as prescribing glasses to correct the eye’s alignment, it’s important to seek expert care early.

Early intervention can:

  • rule out any potentially serious underlying disease
  • identify appropriate treatment to quickly correct the crossed eye and
  • prevent lingering long-term effects.

Boston Children’s Ophthalmologist-in-Chief, David Hunter, MD, PhD, offers advice to pediatricians on what to do when a patient suddenly develops esotropia. …Read More

New study finds nearly half of pediatric clinical trials are abandoned or unpublished

VECTOR_OverlayBooks-800x4501

Where are all the pediatric clinical trials?

Two researchers at Boston Children’s Hospital found a disturbing trend when they searched for data on registered trails involving children.

Natalie Pica, MD and and Florence Bourgeois, MD, MPH took a retrospective, cross-sectional study of pediatric randomized clinical trials (RCTs) registered on ClinicalTrials.gov from 2008 to 2010 and found that 19 percent of were discontinued early. Of those that were actually completed, two thirds had still not published results after an average of 58 months.

Many studies do not publish data because technically, they are only required to report on Clinicaltrials.gov. However, without undergoing appropriate analysis, that data isn’t useful to others.

Our sister blog Vector spoke with Pica and Bourgeois to further investigate this disturbing trend and report on the various roadblocks facing pediatric RTCs.

Read Vector‘s coverage of unpublished pediatric trials.