title: 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.
  
  
  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.
authors.affiliation: Department of Pediatrics, University of Connecticut Health Center, Farmington 06030-3960, USA.
authors.forename: H M
authors.initials: HM
authors.lastname: Feder
authors.forename: M S
authors.initials: MS
authors.lastname: Hunt
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents