Pitfalls in the diagnosis and treatment of Lyme disease in children.
OBJECTIVE
To define pitfalls of diagnosis and treatment of Lyme disease in children.


METHODS
Case series.


METHODS
A university Lyme disease clinic in a Lyme disease endemic area.


METHODS
A total of 146 pediatric patients (mean age, 9.9 years) referred with possible Lyme disease.


METHODS
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.
Feder
H M
HM
Department of Pediatrics, University of Connecticut Health Center, Farmington 06030-3960, USA.
Hunt
M S
MS
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008193:Lyme Disease / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008508:Medication Errors; D012698:Serologic Tests
D000900:Anti-Bacterial Agents