Pitfalls in the diagnosis and treatment of Lyme disease in children
Abstract
OBJECTIVE: To define pitfalls of diagnosis and treatment of Lyme disease in children. DESIGN: Case series. SETTING: A university Lyme disease clinic in a Lyme disease endemic area. PATIENTS: A total of 146 pediatric patients (mean age, 9.9 years) referred with possible Lyme disease. MAIN OUTCOME MEASURES: Of the 146 patients, 56 (38%) were overdiagnosed, 12 (8%) were underdiagnosed, and 75 (51%) were correctly diagnosed with Lyme disease. Treatment errors were made for 19 (25%) of these 75 patients. In addition, three patients (2%) with tick bites were misdiagnosed or mistreated. Frequent pitfalls included misidentifying rashes as erythema migrans, ascribing nonspecific symptoms to Lyme disease, failing to ascribe fleeting objective symptoms to Lyme disease, and inappropriate antibiotic therapy for patients with Lyme disease. CONCLUSIONS: Errors in the diagnosis and treatment of Lyme disease in children are common.
Cited By (2)
References (6)
- Persistence of serum antibodies to Borrelia burgdorferi in patients treated for Lyme diseaseClinical Infectious Diseases · 1992
- Lyme disease: recommendations for diagnosis and treatmentAnnals of Internal Medicine · 1991
- Summary of the first 100 patients seen at a Lyme disease referral centerThe American Journal of Medicine · 1990
- Diagnosis of Lyme disease based on dermatologic manifestationsAnnals of Internal Medicine · 1991
- Performance of 45 Laboratories Participating in a Proficiency Testing Program for Lyme Disease Serology
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