Lyme disease in paediatrics.

The cluster of 39 children with a presumptive diagnosis of juvenile rheumatoid arthritis in Connecticut, around the town of Old Lyme, initiated the research which eventually led to the arthritis being named Lyme arthritis.' The association with a multisystem illness then caused the syndrome to be redefined as Lyme disease. Epidemiologically, an infectious aetiology appeared probable, with ticks as likely vectors for the disease. Clinically, a skin rash, erythema migrans, preceded the development of the arthritis. The skin rash had been first described in Scandinavia in 1913 and associated with tick bites.2 Some patients presented with Bannwarth's syndrome, a meningopolyneuritis associated with tick bites, described in Europe