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van Samkar A, Bruinsma RA, Vermeeren YM, Wieberdink RG, van Bemmel T, Reijer PMD, van Kooten B, Zomer TP. Clinical characteristics of Lyme neuroborreliosis in Dutch children and adults. Eur J Pediatr 2023; 182:1183-1189. [PMID: 36607413 DOI: 10.1007/s00431-022-04749-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 01/07/2023]
Abstract
Lyme neuroborreliosis (LNB) is a tick-borne infection caused by Borrelia burgdorferi which can affect the nervous system in adults and children. The clinical course of LNB in adults is often different than in children. Studies comparing these differences are scarce. The aim of this study was to compare the clinical characteristics and outcome of LNB between children and adults. We performed an observational retrospective study among patients with LNB who presented at Gelre Hospital from 2007 to 2020 and had cerebrospinal fluid pleocytosis. Data were collected from electronic medical records. A total of 127 patients with LNB were identified. Included were 58 children (median age 8 years) and 69 adults (median age 56 years). The incidence of LNB was 3.2 per 100,000 inhabitants per year. The most common neurological manifestation in adults and in children was facial nerve palsy (67%). Unilateral facial nerve palsy was more prevalent in children (85%) than in adults (42%) (P < 0.001). Headache was also more prevalent in children (59%) than in adults (32%) (P = 0.003). (Poly)radiculitis was more prevalent in adults (51%) than in children (3%) (P < 0.001), encephalitis was not reported in children. In children, the time between symptom onset and diagnosis was 10 days versus 28 days in adults (P < 0.001). Complete recovery was reported significantly more often in children (83%) compared to adults (40%) (P < 0.001). Conclusion: In a Lyme-endemic area in the Netherlands, LNB commonly presents with facial nerve palsy. Facial nerve palsy and headache are more prevalent in children, while radiculitis and encephalitis are mostly reported in adults. What is Known: • The clinical course of Lyme neuroborreliosis in adults is often different from children. . • The aim of this study was to compare the clinical characteristics and outcome of LNB between children and adults. What is New: • Lyme neuroborreliosis in the Netherlands commonly presents with facial nerve palsy. • Facial nerve palsy and headache are more prevalent in children than in adults. Radiculitis and encephalitis are mostly reported in adults.
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Affiliation(s)
- A van Samkar
- Lyme Centre Apeldoorn, Gelre Hospital, P.O. Box 9014, 7300 DS, Apeldoorn, the Netherlands
| | - R A Bruinsma
- Lyme Centre Apeldoorn, Gelre Hospital, P.O. Box 9014, 7300 DS, Apeldoorn, the Netherlands
- Department of Pediatrics, Gelre Hospital, Apeldoorn, the Netherlands
| | - Y M Vermeeren
- Lyme Centre Apeldoorn, Gelre Hospital, P.O. Box 9014, 7300 DS, Apeldoorn, the Netherlands
- Department of Internal Medicine, Gelre Hospital, Apeldoorn, the Netherlands
| | - R G Wieberdink
- Lyme Centre Apeldoorn, Gelre Hospital, P.O. Box 9014, 7300 DS, Apeldoorn, the Netherlands
- Department of Neurology, Gelre Hospital, Apeldoorn, the Netherlands
| | - T van Bemmel
- Lyme Centre Apeldoorn, Gelre Hospital, P.O. Box 9014, 7300 DS, Apeldoorn, the Netherlands
- Department of Internal Medicine, Gelre Hospital, Apeldoorn, the Netherlands
| | - P M den Reijer
- Department of Medical Microbiology and Infection Prevention, Gelre Hospital, Apeldoorn, the Netherlands
| | - B van Kooten
- Lyme Centre Apeldoorn, Gelre Hospital, P.O. Box 9014, 7300 DS, Apeldoorn, the Netherlands
| | - T P Zomer
- Lyme Centre Apeldoorn, Gelre Hospital, P.O. Box 9014, 7300 DS, Apeldoorn, the Netherlands.
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Iyer V, Enthoven CA, van Dommelen P, Samkar AV, Groenewoud JH, Reijneveld SA, Jaddoe VWV, Klaver CCW. Spectacle wear and refractive errors in Dutch children. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Myopia is a refractive error that is increasing dramatically all over the world. Early onset is associated with a significant visual burden later in life, but little is known about refractive errors in preschool children. The aim of this study was to assess prevalence of spectacle wear, visual acuity and refractive errors in young Dutch children and to make global comparisons.
Methods
We analyzed data of three prospective population-based studies: 99,660 3- to 5-year-olds undergoing vision screening at preventive child healthcare organizations, 6,934 6-year-olds from the Generation R study, and 2,974 7-year-olds from the RAMSES study. Visual acuity was measured with Landolt-C or LEA charts, spectacle wear was assessed, and refractive errors at age 6 and 7 were measured with cycloplegic refraction. Spectacle wear was compared with international studies.
Results
The prevalence of spectacle wear was 1.5%, 2.3%, 6.6%, 8.2% and 11.8% at 36, 45, 60, 72 and 84 months, respectively, with no major sex differences. Among children with spectacle wear at 72 months (N = 583) and 84 months (N = 351) 29.8% and 34.6% had myopia respectively, of which 21.1% and 21.6% combined with astigmatism, 19.6% and 6.8% had hyperopia, 37.2% and 11.1% hyperopia and astigmatism, and 12.5% and 33.3% astigmatism only. The prevalence of spectacle wear globally varied between 1.5% to 21%.
Conclusions
Spectacle wear in these European children started early in preschool and increased to substantial figures at school age. Among children with spectacle wear, >30% were already myopic, illustrating the urgency to implement myopia prevention strategies in child health centers.
Key messages
Early onset myopia is a public health issue. Of the 6- to 7-year-olds with spectacles 30-34% were already myopic. Monitoring of refractive errors and preventive lifestyle interventions are warranted.
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Affiliation(s)
- V Iyer
- Child Health/Education, TNO, Leiden, Netherlands
| | - CA Enthoven
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, Netherlands
| | | | - A van Samkar
- Resident Geriatric Medicine, Omring, Lutjebroek, Netherlands
| | - JH Groenewoud
- University of Applied Sciences, Rotterdam, Netherlands
| | - SA Reijneveld
- Department of Health Sciences, University Medical Center, Groningen, Netherlands
| | - VWV Jaddoe
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, Netherlands
| | - CCW Klaver
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands
- Department of Ophthalmology, Radboud Medical Center, Nijmegen, Netherlands
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
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van Samkar A, Brouwer MC, Schultsz C, van der Ende A, van de Beek D. Capnocytophaga canimorsus Meningitis: Three Cases and a Review of the Literature. Zoonoses Public Health 2015; 63:442-8. [PMID: 26693951 DOI: 10.1111/zph.12248] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Indexed: 12/12/2022]
Abstract
Bacterial meningitis is a disease with a high morbidity and mortality. It may be caused by the zoonotic pathogen Capnocytophaga canimorsus, which is part of the commensal oral flora in dogs and cats. We report three cases of C. canimorsus meningitis in a nationwide cohort study of bacterial meningitis patients and performed a review of the literature. Three episodes of C. canimorsus meningitis were identified in three patients included in a nationwide cohort study from 2006 through 2014. The calculated annual incidence was 0.03 per million adults. When combined with the literature, 33 patients were identified of which 28 were male (85%). The median age was 63 years, and 13 (42%) were immunocompromised, which consisted of alcoholism in 7 (21%). Animal contact could be established in 29 of 30 patients (93%) and consisted of dog bites in 22 of 29 (76%). One patient died (3%) and 8 had neurological sequelae upon discharge (25%), most often hearing loss (n = 6, 19%). Capnocytophaga canimorsus meningitis is associated with dog bites. Although mortality is relatively low, survivors often have neurological sequelae.
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Affiliation(s)
- A van Samkar
- Department of Neurology, Academic Medical Centre, Centre of Infection and Immunity Amsterdam (CINIMA), Amsterdam, the Netherlands
| | - M C Brouwer
- Department of Neurology, Academic Medical Centre, Centre of Infection and Immunity Amsterdam (CINIMA), Amsterdam, the Netherlands
| | - C Schultsz
- Department of Global Health, Academic Medical Centre, Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands.,Department of Medical Microbiology, Academic Medical Centre, Centre of Infection and Immunity Amsterdam (CINIMA), Amsterdam, the Netherlands
| | - A van der Ende
- Department of Medical Microbiology, Academic Medical Centre, Centre of Infection and Immunity Amsterdam (CINIMA), Amsterdam, the Netherlands.,Netherlands Reference Laboratory for Bacterial Meningitis, Academic Medical Centre, Amsterdam, the Netherlands
| | - D van de Beek
- Department of Neurology, Academic Medical Centre, Centre of Infection and Immunity Amsterdam (CINIMA), Amsterdam, the Netherlands
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van Samkar A, van de Beek D, Stijnis C, Goris M, Brouwer MC. Suspected leptospiral meningitis in adults: report of four cases and review of the literature. Neth J Med 2015; 73:464-470. [PMID: 26687262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Leptospirosis is a widespread zoonotic disease characterised by headache and fever. These symptoms are often suggestive of meningitis, but only a proportion of patients have leptospiral meningitis. METHODS We report episodes of leptospiral meningitis in patients admitted to a tertiary referral centre in the Netherlands, in whom lumbar puncture was performed, and conducted a literature search of adult cases of leptospiral meningitis to describe clinical characteristics and outcome. RESULTS Between 2011 and 2014, 19 patients with leptospirosis were identified. Seven underwent a lumbar puncture for suspected meningitis (37%), of which six had been in contact with fresh water in a tropical area. Four patients with suspected meningitis (57%) had cerebrospinal fluid pleocytosis indicative of leptospiral meningitis and presented with headache, fever and neck stiffness. In a review of the literature we identified 366 patients with leptospiral meningitis with a median age of 33 years (range 17-77). Risk factors for leptospirosis were identified in 32 of 33 patients. Typical cerebrospinal fluid abnormalities consisted of a mildly elevated leukocyte count (median 206 leukocytes/mm3, range 6-2072) with a lymphocytic predominance (median 95%). Outcome was generally favourable, with a mortality rate of 3% and neurological sequelae in 5% of the survivors. CONCLUSION Leptospirosis in the Netherlands has a low incidence. In the case of suspected meningitis and a history of visiting tropical areas or direct or indirect contact with animal urine, leptospiral meningitis should be considered. Cerebrospinal fluid examination is vital for the differential diagnosis of leptospirosis. Outcome is generally favourable in patients with leptospiral meningitis treated with antibiotics.
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Affiliation(s)
- A van Samkar
- Department of Neurology, Academic Medical Centre, Centre of Infection and Immunity Amsterdam (CINIMA), Amsterdam, the Netherlands
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van Samkar A, Brouwer MC, van der Ende A, van de Beek D. Streptococcus equi meningitis. Clin Microbiol Infect 2015; 22:e3-e4. [PMID: 26369601 DOI: 10.1016/j.cmi.2015.09.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 09/03/2015] [Indexed: 11/30/2022]
Affiliation(s)
- A van Samkar
- Department of Neurology, Centre of Infection and Immunity Amsterdam (CINIMA), Amsterdam, The Netherlands
| | - M C Brouwer
- Department of Neurology, Centre of Infection and Immunity Amsterdam (CINIMA), Amsterdam, The Netherlands
| | - A van der Ende
- Department of Medical Microbiology, Centre of Infection and Immunity Amsterdam (CINIMA), Amsterdam, The Netherlands; Netherlands Reference Laboratory for Bacterial Meningitis, Academic Medical Centre, Amsterdam, The Netherlands
| | - D van de Beek
- Department of Neurology, Centre of Infection and Immunity Amsterdam (CINIMA), Amsterdam, The Netherlands.
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