Zakodowany w Twojej głowie obraz rumienia, który “wędruje” od środka na zewnątrz, pozostawiając za sobą bladą skórę, u dzieci lubi płatać figle i przybierać inny, mniej charakterystyczny wygląd. Najwcześniejsza skórna manifestacja zakażenia krętkiem boreliozy jaką jest rumień wędrujący u pacjentów pediatrycznych nie zawsze wpisuje się w typowy schemat, co może prowadzić do trudności diagnostycznych lub prostego pominięcia wczesnego stadium boreliozy w diagnostyce.
U dorosłych, gdy już pojawia się rumień wędrujący ( a nie zawsze to ma miejsce) przyjmuje on zazwyczaj postać zaczerwienia z bladym polem centralnym, które poszerza się obwodowo.
“Czerwono” , ALE DOPIERO PO KILKU DNIACH- czyli zacznijmy od początku
www.enzyklopaedie-dermatologie.de
Kleszcz, który konsumuje swój krwisty posiłek.
Im dłużej przebywa w skórze tym większe prawdopodobieństwo przeniesienia zakażenia krętkiem boreliozy. Oczywiście, nie każdy kleszcz jest zakażony!
www.enzyklopaedie-dermatologie.de
Na obu fotografiach w otoczeniu kleszcza widzisz zaczerwienienie – jego intensywność koreluje dodatnio z czasem jaki spędził on wbity w naszą skórę.
Po usunięciu kleszcza “czerwone” zostaje, jest widoczne jako odczynowa rekacja zapalna na uszkodzenie tkanek – nie oznacza zakażenia boreliozą!! i nie ma nic wspólnego z rumieniem wędrującym.
Jeśli już masz wątpliwą przyjemność usuwać kleszcza ze swojej skóry, postaraj się zauważyć i zapamiętać czy skóra w jego otoczeniu jest czerwona. Jeśli TAK – zrób zdjęcie, zanotuj lub zapamiętaj. To zaczerwienienie, które pojawia się gdy kleszcz jeszcze spożywa swój krwisty posiłek lub w ciągu 24 h od jego usunięcia jest odczynowym stanem zapalnym NA USZKODZENIE TKANKI – NIE NA ZAKAŻENIE BORELIOZĄ! To nie jest początek rumienia wędrującego.
Rumień związany z boreliozą pojawia się od kilku do kilkunastu dni po usunięciu kleszcza, najczęściej, gdy my już zdążyliśmy o całej kleszczowej akcji zapomnieć. Nie powoduje on praktycznie żadnych objawów, które mogłyby spowodować nasz dyskomfort, dlatego jeśli jest w ukrytym przed naszymi oczami miejscu możemy go łatwo przeoczyć.
Decydujące 24h – oglądamy skórę dziecka codziennie wieczorem
Na załączonym diagramie możesz zobaczyć te decydujące 24 h od momentu wbicia się kleszcza. Po ich upływie ryzyko transportu krętka boreliozy na człowieka znacząco wzrasta. Dzieje się tak dlatego, że krętki żyją w jelicie kleszcza. Aby móc dostać się do naszego organizmu muszą najpierw dotrzeć do gruczołów ślinowych kleszcza, a ta droga zajmuje im mniej więcej 24 h. Jaki z tego wniosek dla nas? – jeśli usuniemy go przed dotarciem bakterii do kleszczowej śliny możemy uchronić się przed zakażeniem.
Dzieci, szczególnie w okresie letnim codziennie przebywają na świeżym powietrzu, mając często kontakt z trawą na placach zabaw czy przydomowych ogrodach. Mylnym jest przekonanie, że jak kleszcz to TYLKO w lesie! Otóż kleszcz odnajdzie Cię również w pobliżu Twojego domu. Dlatego tak ważne jest, aby podczas kąpieli czy zakładaniu piżamy do snu obejrzeć skórę swojego dziecka pod kątem ewentualnych nieproszonych gości. Do kolejnego wieczoru minie akurat te 24 h więc warto wyrobić sobie taki letni “kleszczowy” nawyk wieczornego oglądania skóry.
Głowa i szyja!
U dzieci inaczej… niż u nas, dorosłych
- CZĘSTA lokalizacja kleszcza w okolicy głowy i szyi! Oglądamy szczególnie za uszami i na karku pod liną włosów! 49% vs 2% u dorosłych!
- Słabiej wyrażony stan zapalny niż u dorosłych – jeszcze jeden czynnik, który “dokłada” do przeoczenia rumienia
- RÓŻNORODNOŚĆ prezentowania się rumienia związanego z wczesną fazą boreliozy – czyt. nie zawsze będzie u dzieci to charakterystyczne “wędrowanie” rumienia ku obwodowi zmiany skórnej
Różnorodność wyglądu rumienia wędrującego u dzieci – #InnyNiżWszystkie
źródło dla poniższych zdjęć to książka: Pädiatrische Dermatologie, Traupe, Hamm
Tutaj widzisz typowy przebieg – wędrowanie “czerwonego” ( rumień) ku obwodowi zmiany skórnej i pozostawianie za sobą blednącej skóry.
Czujność przy rumieniach “plamkowatych” i “napadowych”
Okolica głowy i szyi + rumień o jednorodnej barwie, bez charakterystycznego “wędrowania”.
Policzki!!
U dzieci, szczególnie w sezonie od maja do końca sierpnia musimy zawsze pomyśleć o boreliozie, gdy w grę wchodzą zaczerwienia, nawet te “plackowate” czy napadowe z ograniczoną lokalizacją, którym nie towarzyszą inne objawy.
Na zdjęciu rumień “plamkowaty” będący odpowiednikiem rumienia wędrującego.
Konkluzja
- Jesteś czujny i oglądasz skórę swojego dziecka pod kątem kleszczowym, aby móc usunąć go jeszcze tego samego dnia #Ważne24Godziny,
- Jeśli kleszcz zostanie usunięty obserwujesz tę okolicę minimum przez tydzień – nawet do 14 dni pod kątem ewentualnego rumienia,
- Okolica głowy i szyi to niezwykle lubiana przez kleszcze część ciała u dzieci.
5 218 komentarzy
Witam, mam pytanie. Moj syn w wieku ok 1,5 roku został ugryziony w głowę. Po ok. Tygodniu na szyji pojawiło sie u niego u niego plackowate na ok 10 cm srednicy miejsce. Po ok 4 – 5 dniach zniknęlo. Oczywiście widział to lekarz i nie stwiredził rumienia. Syn noe zglaszał żadnych dolegliwosci poza tym ze mocno e tym miejscu sie drapał. Po ok 7 tyg zeobilismy standardowe badania z krwi ktore wyszły e normie. Czy mimo wszystko mogło dojsc do zakażenia? Syn ma teraz ponad 3 lata.
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