Yearly Occurrence and Seasonality of Neuro-ophthalmic Manifestations of Pediatric Lyme Disease
To review the neuro-ophthalmic manifestations of Lyme disease at a central Ohio pediatric tertiary care center. A retrospective chart review of patients diagnosed as having Lyme disease from September 2015 to September 2020 was completed. Demographic information, diagnosis dates, and manifestations...
Saved in:
Published in | Journal of pediatric ophthalmology and strabismus Vol. 61; no. 3; pp. 179 - 182 |
---|---|
Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
United States
Slack, Inc
01.05.2024
SLACK INCORPORATED |
Subjects | |
Online Access | Get full text |
Cover
Loading…
Abstract | To review the neuro-ophthalmic manifestations of Lyme disease at a central Ohio pediatric tertiary care center.
A retrospective chart review of patients diagnosed as having Lyme disease from September 2015 to September 2020 was completed. Demographic information, diagnosis dates, and manifestations of Lyme disease were recorded. Patients were excluded for age older than 18 years or lack of corroborated Lyme disease diagnosis. Descriptive statistics were performed.
Of the 212 cases of pediatric Lyme disease reviewed, 50 patients had neuroborreliosis. The data showed an increase in Lyme disease and neuroborreliosis cases from 2018 to 2020, with a preponderance of diagnoses in the summer months. Twenty-four patients had meningitis, and 6 of these patients (25%) were diagnosed as having bilateral optic disc edema that was clinically consistent with intracranial hypertension.
Papilledema in the setting of Lyme meningitis may be more common than previously reported in central Ohio. If Lyme disease meningitis is suspected, an opening pressure should be recorded at the time of lumbar puncture and, if elevated, an ophthalmologic evaluation for optic nerve edema is indicated.
. |
---|---|
AbstractList | Purpose: To review the neuro-ophthalmic manifestations of Lyme disease at a central Ohio pediatric tertiary care center. Methods: A retrospective chart review of patients diagnosed as having Lyme disease from September 2015 to September 2020 was completed. Demographic information, diagnosis dates, and manifestations of Lyme disease were recorded. Patients were excluded for age older than 18 years or lack of corroborated Lyme disease diagnosis. Descriptive statistics were performed. Results: Of the 212 cases of pediatric Lyme disease reviewed, 50 patients had neuroborreliosis. The data showed an increase in Lyme disease and neuroborreliosis cases from 2018 to 2020, with a preponderance of diagnoses in the summer months. Twenty-four patients had meningitis, and 6 of these patients (25%) were diagnosed as having bilateral optic disc edema that was clinically consistent with intracranial hypertension. Conclusions: Papilledema in the setting of Lyme meningitis may be more common than previously reported in central Ohio. If Lyme disease meningitis is suspected, an opening pressure should be recorded at the time of lumbar puncture and, if elevated, an ophthalmologic evaluation for optic nerve edema is indicated. [J Pediatr Ophthalmol Strabismus. 20XX;X(X):XXX–XXX.] Purpose: To review the neuro-ophthalmic manifestations of Lyme disease at a central Ohio pediatric tertiary care center. Methods: A retrospective chart review of patients diagnosed as having Lyme disease from September 2015 to September 2020 was completed. Demographic information, diagnosis dates, and manifestations of Lyme disease were recorded. Patients were excluded for age older than 18 years or lack of corroborated Lyme disease diagnosis. Descriptive statistics were performed. Results: Of the 212 cases of pediatric Lyme disease reviewed, 50 patients had neuroborreliosis. The data showed an increase in Lyme disease and neuroborreliosis cases from 2018 to 2020, with a preponderance of diagnoses in the summer months. Twenty-four patients had meningitis, and 6 of these patients (25%) were diagnosed as having bilateral optic disc edema that was clinically consistent with intracranial hypertension. Conclusions: Papilledema in the setting of Lyme meningitis may be more common than previously reported in central Ohio. If Lyme disease meningitis is suspected, an opening pressure should be recorded at the time of lumbar puncture and, if elevated, an ophthalmologic evaluation for optic nerve edema is indicated. [ J Pediatr Ophthalmol Strabismus . 2024;61(3):179–182.] To review the neuro-ophthalmic manifestations of Lyme disease at a central Ohio pediatric tertiary care center. A retrospective chart review of patients diagnosed as having Lyme disease from September 2015 to September 2020 was completed. Demographic information, diagnosis dates, and manifestations of Lyme disease were recorded. Patients were excluded for age older than 18 years or lack of corroborated Lyme disease diagnosis. Descriptive statistics were performed. Of the 212 cases of pediatric Lyme disease reviewed, 50 patients had neuroborreliosis. The data showed an increase in Lyme disease and neuroborreliosis cases from 2018 to 2020, with a preponderance of diagnoses in the summer months. Twenty-four patients had meningitis, and 6 of these patients (25%) were diagnosed as having bilateral optic disc edema that was clinically consistent with intracranial hypertension. Papilledema in the setting of Lyme meningitis may be more common than previously reported in central Ohio. If Lyme disease meningitis is suspected, an opening pressure should be recorded at the time of lumbar puncture and, if elevated, an ophthalmologic evaluation for optic nerve edema is indicated. . To review the neuro-ophthalmic manifestations of Lyme disease at a central Ohio pediatric tertiary care center. A retrospective chart review of patients diagnosed as having Lyme disease from September 2015 to September 2020 was completed. Demographic information, diagnosis dates, and manifestations of Lyme disease were recorded. Patients were excluded for age older than 18 years or lack of corroborated Lyme disease diagnosis. Descriptive statistics were performed. Of the 212 cases of pediatric Lyme disease reviewed, 50 patients had neuroborreliosis. The data showed an increase in Lyme disease and neuroborreliosis cases from 2018 to 2020, with a preponderance of diagnoses in the summer months. Twenty-four patients had meningitis, and 6 of these patients (25%) were diagnosed as having bilateral optic disc edema that was clinically consistent with intracranial hypertension. Papilledema in the setting of Lyme meningitis may be more common than previously reported in central Ohio. If Lyme disease meningitis is suspected, an opening pressure should be recorded at the time of lumbar puncture and, if elevated, an ophthalmologic evaluation for optic nerve edema is indicated. PURPOSETo review the neuro-ophthalmic manifestations of Lyme disease at a central Ohio pediatric tertiary care center.METHODSA retrospective chart review of patients diagnosed as having Lyme disease from September 2015 to September 2020 was completed. Demographic information, diagnosis dates, and manifestations of Lyme disease were recorded. Patients were excluded for age older than 18 years or lack of corroborated Lyme disease diagnosis. Descriptive statistics were performed.RESULTSOf the 212 cases of pediatric Lyme disease reviewed, 50 patients had neuroborreliosis. The data showed an increase in Lyme disease and neuroborreliosis cases from 2018 to 2020, with a preponderance of diagnoses in the summer months. Twenty-four patients had meningitis, and 6 of these patients (25%) were diagnosed as having bilateral optic disc edema that was clinically consistent with intracranial hypertension.CONCLUSIONSPapilledema in the setting of Lyme meningitis may be more common than previously reported in central Ohio. If Lyme disease meningitis is suspected, an opening pressure should be recorded at the time of lumbar puncture and, if elevated, an ophthalmologic evaluation for optic nerve edema is indicated. [J Pediatr Ophthalmol Strabismus. 2024;61(3):179-182.]. Purpose: To review the neuro-ophthalmic manifestations of Lyme disease at a central Ohio pediatric tertiary care center. Methods: A retrospective chart review of patients diagnosed as having Lyme disease from September 2015 to September 2020 was completed. Demographic information, diagnosis dates, and manifestations of Lyme disease were recorded. Patients were excluded for age older than 18 years or lack of corroborated Lyme disease diagnosis. Descriptive statistics were performed. Results: Of the 212 cases of pediatric Lyme disease reviewed, 50 patients had neuroborreliosis. The data showed an increase in Lyme disease and neuroborreliosis cases from 2018 to 2020, with a preponderance of diagnoses in the summer months. Twenty-four patients had meningitis, and 6 of these patients (25%) were diagnosed as having bilateral optic disc edema that was clinically consistent with intracranial hypertension. Conclusions: Papilledema in the setting of Lyme meningitis may be more common than previously reported in central Ohio. If Lyme disease meningitis is suspected, an opening pressure should be recorded at the time of lumbar puncture and, if elevated, an ophthalmologic evaluation for optic nerve edema is indicated. [J Pediatr Ophthalmol Strabismus. 2024;61(3):179–182.] |
Audience | Academic |
Author | Aylward, Shawn C Inger, Hilliary Silverstein, Marlee Jordan, Catherine O |
Author_xml | – sequence: 1 givenname: Marlee surname: Silverstein fullname: Silverstein, Marlee – sequence: 2 givenname: Catherine O surname: Jordan fullname: Jordan, Catherine O – sequence: 3 givenname: Shawn C surname: Aylward fullname: Aylward, Shawn C – sequence: 4 givenname: Hilliary surname: Inger fullname: Inger, Hilliary |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/37882186$$D View this record in MEDLINE/PubMed |
BookMark | eNp9kUFv1DAQhS3Uim4L_wChSFy4pNgzjhMfqwIFaWkrAQcuWN5kTF0l8dZODvvv66hdEAhVtmRp_L3nGb9jdjCGkRh7JfgpamjecaEF5l0CBxScVyUXz9hKaGxKkLw6YKsFKRfmiB2ndMu5kFrDc3aEddOAaNSK_fxBNva74qpt5xhpbKmwY1d8JZvCaHs_7YrgikuaYyjD9ma6sf3g2-KLHb2jNNnJhzEtyDV13k4x3613AxXvfcoW9IIdOtsnevl4nrDvHz98O_9Urq8uPp-frcsWuZ5KtNhI3YnaoeLQKa1AOK6kFARoSVeYJ3ESkCwAl1IDdtJtxEYrrKmTeMLePvhuY7ibc2Nm8KmlvrcjhTkZyPMiVIqrjL75B70Nc8yzJoO80lI0GvlTVPYSChXU8If6ZXsyfnRhirZdnjZndY2y0VDVmTr9D5VXR_kvc6rO5_pfAvkgaGNIKZIz2-gHG3dGcLOEb_bhm334uZJlrx97njcDdb9F-7TxHgdmpzo |
Cites_doi | 10.1177/1120672119856943 10.1212/CON.0000000000000252 10.1007/s00415-015-8007-x 10.1016/j.survophthal.2016.03.011 10.1016/0039-6257(90)90089-E 10.1016/j.ophtha.2003.08.032 10.1016/j.idc.2015.02.011 10.1016/j.jaad.2016.08.014 10.1186/s12879-016-2112-z 10.1155/2021/5565900 |
ContentType | Journal Article |
Copyright | COPYRIGHT 2023 Slack, Inc. Copyright 2023, SLACK Incorporated Copyright 2024, SLACK Incorporated |
Copyright_xml | – notice: COPYRIGHT 2023 Slack, Inc. – notice: Copyright 2023, SLACK Incorporated – notice: Copyright 2024, SLACK Incorporated |
DBID | CGR CUY CVF ECM EIF NPM AAYXX CITATION 3V. 7X7 7XB 88E 88I 8AF 8FI 8FJ 8FK ABUWG AFKRA AZQEC BENPR CCPQU DWQXO FYUFA GHDGH GNUQQ HCIFZ K9. M0S M1P M2P PQEST PQQKQ PQUKI PRINS Q9U S0X 7X8 |
DOI | 10.3928/01913913-20231005-01 |
DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed CrossRef ProQuest Central (Corporate) Health & Medical Collection ProQuest Central (purchase pre-March 2016) Medical Database (Alumni Edition) Science Database (Alumni Edition) STEM Database Hospital Premium Collection Hospital Premium Collection (Alumni Edition) ProQuest Central (Alumni) (purchase pre-March 2016) ProQuest Central (Alumni) ProQuest Central ProQuest Central Essentials ProQuest Central ProQuest One Community College ProQuest Central Korea Health Research Premium Collection Health Research Premium Collection (Alumni) ProQuest Central Student SciTech Premium Collection ProQuest Health & Medical Complete (Alumni) Health & Medical Collection (Alumni Edition) PML(ProQuest Medical Library) Science Database ProQuest One Academic Eastern Edition (DO NOT USE) ProQuest One Academic ProQuest One Academic UKI Edition ProQuest Central China ProQuest Central Basic SIRS Editorial MEDLINE - Academic |
DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) CrossRef ProQuest Central Student ProQuest Central Essentials SIRS Editorial ProQuest Health & Medical Complete (Alumni) ProQuest AP Science ProQuest Central (Alumni Edition) SciTech Premium Collection ProQuest One Community College ProQuest Central China ProQuest Central Health Research Premium Collection Health and Medicine Complete (Alumni Edition) ProQuest Central Korea ProQuest Medical Library (Alumni) ProQuest Science Journals (Alumni Edition) ProQuest Central Basic ProQuest Science Journals ProQuest One Academic Eastern Edition ProQuest Hospital Collection Health Research Premium Collection (Alumni) ProQuest Hospital Collection (Alumni) ProQuest Health & Medical Complete ProQuest Medical Library ProQuest One Academic UKI Edition ProQuest One Academic ProQuest Central (Alumni) MEDLINE - Academic |
DatabaseTitleList | CrossRef MEDLINE MEDLINE - Academic ProQuest Central Student ProQuest Central Student |
Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database – sequence: 3 dbid: BENPR name: ProQuest Central url: https://www.proquest.com/central sourceTypes: Aggregation Database |
DeliveryMethod | fulltext_linktorsrc |
Discipline | Medicine |
EISSN | 1938-2405 |
EndPage | 182 |
ExternalDocumentID | A773489257 10_3928_01913913_20231005_01 37882186 |
Genre | Journal Article |
GeographicLocations | Ohio United States--US |
GeographicLocations_xml | – name: Ohio – name: United States--US |
GroupedDBID | --- .GJ 0R~ 29L 354 36B 3O- 3V. 4.4 53G 5GY 5RE 7X7 88E 88I 8AF 8FI 8FJ ABCQX ABPPZ ABUWG ACGFS ACGOD ACNCT ADBBV AENEX AFKRA AHMBA ALIPV ALMA_UNASSIGNED_HOLDINGS AZQEC BENPR BPHCQ BVXVI C45 CCPQU CGR CUY CVF DU5 DWQXO EBD EBS ECM EIF EJD EMB EMOBN F5P FYUFA GNUQQ HCIFZ HMCUK HZ~ IAO IHR INH ITC L7B M1P M2P M2Q NPM O9- OVD PQQKQ PROAC PSQYO RWG S0X SJN SV3 TEORI UKHRP WH7 ZGI ZXP AAYXX CITATION 7XB 8FK K9. PQEST PQUKI PRINS Q9U 7X8 |
ID | FETCH-LOGICAL-c309t-3a3849d17f3602d69621f06441e23ae953191f423ea22044923d4fb1b9637ed43 |
IEDL.DBID | 7X7 |
ISSN | 0191-3913 |
IngestDate | Wed Jul 17 03:17:46 EDT 2024 Tue Sep 24 22:48:34 EDT 2024 Tue Sep 24 22:16:29 EDT 2024 Fri Feb 23 00:22:18 EST 2024 Sat Dec 16 00:35:57 EST 2023 Thu Sep 26 17:59:17 EDT 2024 Wed Oct 09 10:22:51 EDT 2024 |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 3 |
Language | English |
LinkModel | DirectLink |
MergedId | FETCHMERGED-LOGICAL-c309t-3a3849d17f3602d69621f06441e23ae953191f423ea22044923d4fb1b9637ed43 |
Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
PMID | 37882186 |
PQID | 2881636272 |
PQPubID | 35531 |
PageCount | 4 |
ParticipantIDs | proquest_miscellaneous_2882325606 proquest_journals_3059418930 proquest_journals_2881636272 gale_infotracmisc_A773489257 gale_infotracacademiconefile_A773489257 crossref_primary_10_3928_01913913_20231005_01 pubmed_primary_37882186 |
PublicationCentury | 2000 |
PublicationDate | 2024-05-01 |
PublicationDateYYYYMMDD | 2024-05-01 |
PublicationDate_xml | – month: 05 year: 2024 text: 2024-05-01 day: 01 |
PublicationDecade | 2020 |
PublicationPlace | United States |
PublicationPlace_xml | – name: United States – name: Thorofare |
PublicationTitle | Journal of pediatric ophthalmology and strabismus |
PublicationTitleAlternate | J Pediatr Ophthalmol Strabismus |
PublicationYear | 2024 |
Publisher | Slack, Inc SLACK INCORPORATED |
Publisher_xml | – name: Slack, Inc – name: SLACK INCORPORATED |
References | e_1_3_1_8_2 e_1_3_1_13_2 e_1_3_1_7_2 e_1_3_1_12_2 e_1_3_1_11_2 e_1_3_1_9_2 e_1_3_1_10_2 e_1_3_1_4_2 e_1_3_1_3_2 e_1_3_1_6_2 e_1_3_1_5_2 e_1_3_1_2_2 |
References_xml | – ident: e_1_3_1_7_2 doi: 10.1177/1120672119856943 – ident: e_1_3_1_10_2 doi: 10.1212/CON.0000000000000252 – ident: e_1_3_1_4_2 doi: 10.1007/s00415-015-8007-x – ident: e_1_3_1_6_2 doi: 10.1016/j.survophthal.2016.03.011 – ident: e_1_3_1_11_2 doi: 10.1016/0039-6257(90)90089-E – ident: e_1_3_1_8_2 doi: 10.1016/j.ophtha.2003.08.032 – ident: e_1_3_1_3_2 doi: 10.1016/j.idc.2015.02.011 – ident: e_1_3_1_5_2 doi: 10.1016/j.jaad.2016.08.014 – ident: e_1_3_1_9_2 – ident: e_1_3_1_12_2 doi: 10.1186/s12879-016-2112-z – ident: e_1_3_1_2_2 – ident: e_1_3_1_13_2 doi: 10.1155/2021/5565900 |
SSID | ssj0014992 |
Score | 2.3913467 |
Snippet | To review the neuro-ophthalmic manifestations of Lyme disease at a central Ohio pediatric tertiary care center.
A retrospective chart review of patients... Purpose: To review the neuro-ophthalmic manifestations of Lyme disease at a central Ohio pediatric tertiary care center. Methods: A retrospective chart review... Purpose: To review the neuro-ophthalmic manifestations of Lyme disease at a central Ohio pediatric tertiary care center. Methods: A retrospective chart review... To review the neuro-ophthalmic manifestations of Lyme disease at a central Ohio pediatric tertiary care center. A retrospective chart review of patients... PURPOSETo review the neuro-ophthalmic manifestations of Lyme disease at a central Ohio pediatric tertiary care center.METHODSA retrospective chart review of... |
SourceID | proquest gale crossref pubmed |
SourceType | Aggregation Database Index Database |
StartPage | 179 |
SubjectTerms | Adolescent Antibiotics Child Child, Preschool Children Children & youth Diagnostic tests Diseases Edema Erythema Eye Infections, Bacterial - diagnosis Eye Infections, Bacterial - epidemiology Eye Infections, Bacterial - microbiology Female Hospitals Humans Hypertension Hypertension in children Incidence Infant Inflammation Lyme disease Lyme Disease - complications Lyme Disease - diagnosis Lyme Disease - epidemiology Lyme Neuroborreliosis - complications Lyme Neuroborreliosis - diagnosis Lyme Neuroborreliosis - epidemiology Male Meningitis Nervous system Neurological disorders Ohio - epidemiology Ophthalmology Optic nerve Papilledema - diagnosis Papilledema - etiology Patients Pediatrics Population Retrospective Studies Seasonal variations Seasons |
Title | Yearly Occurrence and Seasonality of Neuro-ophthalmic Manifestations of Pediatric Lyme Disease |
URI | https://www.ncbi.nlm.nih.gov/pubmed/37882186 https://www.proquest.com/docview/2881636272/abstract/ https://www.proquest.com/docview/3059418930/abstract/ https://www.proquest.com/docview/2882325606/abstract/ |
Volume | 61 |
hasFullText | 1 |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV1Li9swEB6yCSx7Kdt2d-s2DSoUehKxHn6dyj4SQmlCaRvIXtbItswWGjtNvIf--874kZJQerQkZDTSSN9oRt8AvFeJwXPO87gwCN8QEbs8wW-uMxFkRnuJNWQozhf-bKk_rbxVD2bdWxgKq-z2xHqjzsqU7sjHiohFBJ6u7tgkdAuQVuOPm1-c8keRn7VNpnECAyERVuDKDlZ70wvNgDo9MuIZwVUkVPOIDrFBOKYyKuKUSFy4dSzbwSF1vFUfAdD6IJqew7MWQbLrZsqfQ88WL-B03vrIX8LDvSXSYkb8wdv6LR8zRca-WdOhblbmrCbl4OXmsXo0P9c_UjY3FOWyazzzO2qyz-LBPv9eW3bXuHIuYDmdfL-d8TaLAk-VG1VcGRXqCEWfK9-VmR_5UuQuwSArlbERKaHIEVVZI6WribAt03kiElTNwGZaXUK_KAv7CpjxAh3lOkhDnes0R1sEzQ3fhlniG61S5QDvxBZvGrKMGI0MEnPciTnuxIwlDnwg2cakSzSjpn0SgH8jVqr4OiDunQh3FQeGBy1RB9LD6m524lYHd7EMQwSbvgzkP6v_LigH3u2rqWMKOyts-VR3gYgTQaHvwFUz6fuBERE_JfR6_f_O38AZjlg3MZJD6FfbJ_sWcUyVjOolOoLBzWTx5esfEDvsFQ |
link.rule.ids | 315,786,790,12083,21416,27957,27958,31754,31755,33779,33780,43345,43840,74102,74659 |
linkProvider | ProQuest |
linkToHtml | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV1Lb9QwEB7BVipcKqA8UlowEhInq_EjrxMqfWiB3RUqrVQuWE7iqEhtst1ND_33zCTOVlshjrEtRx6_vvHMfAPwUeUW77ko4sIifENEHPIcv7kuRVJaHeXOkqI4ncXjc_3tIrrwD25L71Y5nIndQV02Bb2R7ysiFhF4u4af5zecskaRddWn0HgMG1qhqjKCjS_Hsx-nKzsC4nnZB0wLrjKh-uA5xATpPpVREacE4iLsfNjWLqeHR_QD4NldQCfPYMsjR3bQT_VzeOTqF7A59bbxbfj9yxFZMSPe4EUXw8dsXbKfzg5omzUV68g4eDO_bC_t1fWfgk0tebcse4v8kpqssnewyd21Y0e9CeclnJ8cnx2Ouc-ewAsVZi1XFiWSocgrFYeyjLNYiiok-OOksi6jzScqRFPOShlqImordZWLHLdk4kqtXsGobmr3BpiNEp1VOilSXemiQh0E1YzYpWUeW60KFQAfxGbmPUmGQeWCxGwGMZtBzFgSwCeSraE91C5sYX0oAP6N2KjMQUKcOxmeJgHsrrXEtV-sVw-zY_zeWxqZpggyY5nIf1bfL6QAPqyqqWNyN6tdc9t1gUgTwWAcwOt-0lcDIwJ-SuS18__O38OT8dl0YiZfZ9_fwlMcve79JHdh1C5u3R5imTZ_5xfsX0AZ6xQ |
linkToPdf | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV1La9wwEB6aFEIupY88nKatAoWcxFqW_DqV0HRJm2woNIHNJUK2JTbQ2Jtd59B_3xlb3rCh9GhJyHik0XzjGX0D8FkWBu1cHHNhEL4hIg55gc9cVSKtjIoLa8hRnFwmZ9fqxzSe-vynpU-rHM7E7qCumpL-kY8kEYsItK7hyPm0iJ-n4y_zB04VpCjS6stpbMBLtJIhVTNIpyvnCx2BrkAyIhrBZS5kf40O0UE2ojZq4lRKXIRdNtuamXp-WD-DoJ0pGr-GVx5DspN-0d_AC1u_ha2Jj5K_g9sbS7TFjBiEF91tPmbqiv2yZsDdrHGso-XgzXzWzszv-7uSTQzluSz72PyShqzqeLCLP_eWnfbBnB24Hn-7-nrGfR0FXsowb7k0MlM5Ct_JJIyqJE8i4UICQjaSxuakhsIhrrImikJFlG2VcoUoUDlTWym5C5t1U9t9YCZOVe5UWmbKqdKhN4IOR2KzqkiMkqUMgA9i0_OeLkOjm0Fi1oOY9SBmbAngmGSrSZvahSmNvxSAbyNeKn2SEvtOjudKAIdrI1ELyvXuYXW018KljrIM4WYSpdE_u5-2VABHq26amBLPats8dlMg5kRYmASw1y_66sOIip9Keh38f_JPsIU7VV98vzx_D9v48apPmDyEzXbxaD8gqGmLj91u_QtvM-3a |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Yearly+Occurrence+and+Seasonality+of+Neuro-ophthalmic+Manifestations+of+Pediatric+Lyme+Disease&rft.jtitle=Journal+of+pediatric+ophthalmology+and+strabismus&rft.au=Silverstein%2C+Marlee&rft.au=Jordan%2C+Catherine+O&rft.au=Aylward%2C+Shawn+C&rft.au=Inger%2C+Hilliary&rft.date=2024-05-01&rft.pub=Slack%2C+Inc&rft.issn=0191-3913&rft.eissn=1938-2405&rft.spage=1&rft_id=info:doi/10.3928%2F01913913-20231005-01&rft.externalDocID=A773489257 |
thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0191-3913&client=summon |
thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0191-3913&client=summon |
thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0191-3913&client=summon |