title: Diagnosis of Lyme disease in the pediatric acute care setting.
abstract: We review the current evidence concerning the diagnosis of Lyme disease in children for application in the acute care setting.
  
  
  
  Recent studies suggest that Lyme disease incidence is substantially higher than previously described. Although efforts are ongoing to identify alternative testing strategies, two-tiered serologic testing remains the diagnostic standard in children with compatible clinical syndromes. Published clinical prediction rules can assist clinicians caring for children with potential Lyme disease.
  
  
  
  Two-tiered serologic testing remains the mainstay of the diagnosis of Lyme disease. To minimize the risk of a false positive test, serologic testing should be limited to those children with symptoms compatible with Lyme disease with potential exposure to ticks from endemic regions.
authors.affiliation: Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
authors.forename: Susan C
authors.initials: SC
authors.lastname: Lipsett
authors.forename: Lise E
authors.initials: LE
authors.lastname: Nigrovic
mesh_terms: D002648:Child; D005188:False Negative Reactions; D005189:False Positive Reactions; D006801:Humans; D015994:Incidence; D008193:Lyme Disease / Q000175:diagnosis* / Q000453:epidemiology; D010372:Pediatrics; D017410:Practice Guidelines as Topic; D012680:Sensitivity and Specificity; D012698:Serologic Tests / Q000379:methods* / Q000639:trends; D014481:United States / Q000453:epidemiology