Tick inoculation in an eyelid region: report on five cases with one complication of the orbital myositis associated with Lyme borreliosis.

PURPOSE: To determine the frequency and dependence of Lyme borreliosis after tick infestation in the eyelid region.

MATERIAL AND

METHODS

Five patients after tick inoculation were investigated by immunofluorescence assays for IgM and IgG system). Ophthalmologic evaluation of myositis was supported with MRI, laboratory, and internal clinical investigations.

RESULTS

Four children showed negative Borrelia serology after a bite from a tick. In one case the left abducens nerve palsy was found, which was diagnosed in MRI as a thickened left lateral rectus muscle. The diagnosis of myositis with positive Borrelia burgdorferi serology was consistent with Lyme borreliosis. Other laboratory examinations were negative. The symptoms were reduced after treatment with ceftriaxon.

CONCLUSIONS

Lyme borreliosis was found in one in five patients after tick infestation in the eyelid region. Antibiotic prophylaxis against Lyme borreliosis with ampicillin is recommended for children after a tick bite.