Lyme Disease in Infants: 5-Week-Old Girl Case

Lyme disease can occasionally affect very young infants. In this Inside Lyme Podcast episode, Dr. Daniel Cameron reviews a case involving a 5-week-old girl who required hospitalization and treatment for suspected Lyme meningitis.

Dr. Cameron often notes that the best way to understand Lyme disease is by reviewing real clinical cases. This case involving Lyme disease in an infant was first described in the journal Pediatrics by Handel and colleagues in 2019.

Concern for Lyme Meningitis

The physicians caring for the infant were concerned that the child might have Lyme meningitis. Lyme meningitis is an uncommon but important complication of Lyme disease that can occur when the infection affects the nervous system.

Doctors typically confirm meningitis through a spinal tap (lumbar puncture). In this case, however, the spinal tap was unsuccessful, leaving uncertainty about whether the infection had reached the central nervous system.

Because Lyme meningitis can be serious if untreated, the physicians chose to proceed with treatment using intravenous antibiotics.

Treatment for Suspected Lyme Meningitis

The infant received intravenous ceftriaxone, a commonly used antibiotic for neurologic Lyme disease. The physicians continued treatment while monitoring the child closely for improvement.

After two weeks of intravenous antibiotic therapy, the infant improved and was discharged from the hospital.

Why Lyme Disease in Infants Can Be Difficult to Recognize

Diagnosing Lyme disease in infants can be challenging. Symptoms may be subtle, and young children cannot describe symptoms such as headache, neck stiffness, or fatigue.

In areas where Lyme disease is common, clinicians may need to consider Lyme infection when infants present with unexplained fever or neurologic symptoms.

Tick bites can also transmit additional infections such as Babesia or other Lyme disease coinfections, which may further complicate diagnosis.

Clinical Takeaway

This case highlights how Lyme disease can affect even very young infants and why clinicians must remain alert for neurologic complications such as Lyme meningitis.

Early recognition and treatment are essential to prevent complications and ensure recovery.

Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.

Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention