Functional Symptoms in Infectious Disease: Reading into Titers

Abstract

Most childhood infections are acute in nature and therefore less likely to result in emergence of functional symptoms typical of chronic conditions. However, human immunodeficiency virus infection (HIV) and Lyme disease, each for a different reason, remain exceptions. In the era of effective antiretroviral therapies, HIV has become a chronic illness. Children born with HIV face different stresses when compared to adolescents who acquire HIV through risky behavior. This chapter will provide a discussion of various mental health problems that accompany or mimic conditions associated with HIV infection that providers are likely to encounter when caring for children with HIV. Lyme disease is an acute illness with excellent prognosis when treated appropriately. Unfortunately, misleading information available on the Internet has fueled false beliefs about Lyme disease diagnosis, treatment, and prognosis. As a result, we have encountered a growing number of older children and adolescents with so-called chronic Lyme disease or post-Lyme disease syndrome. Because their definitions remain elusive, patients with subjective complaints often are diagnosed with Lyme disease. Proper knowledge of clinical manifestations of Lyme disease and interpretation of Lyme serology testing are paramount to prevention of unnecessary and misleading interventions. This chapter will focus on the challenges of Lyme disease diagnostics and treatment in patients presenting with functional symptoms.