Feder H M, Hunt M S
Department of Pediatrics, University of Connecticut Health Center, Farmington 06030-3960, USA.
JAMA. 1995 Jul 5;274(1):66-8.
To define pitfalls of diagnosis and treatment of Lyme disease in children.
Case series.
A university Lyme disease clinic in a Lyme disease endemic area.
A total of 146 pediatric patients (mean age, 9.9 years) referred with possible Lyme disease.
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.
Errors in the diagnosis and treatment of Lyme disease in children are common.
明确儿童莱姆病诊断和治疗中的陷阱。
病例系列研究。
莱姆病流行地区的一所大学莱姆病诊所。
共146例疑似莱姆病的儿科患者（平均年龄9.9岁）。
146例患者中，56例（38%）被过度诊断，12例（8%）被漏诊，75例（51%）被正确诊断为莱姆病。这75例患者中有19例（25%）存在治疗错误。此外，3例（2%）蜱叮咬患者被误诊或误治。常见陷阱包括将皮疹误诊为游走性红斑、将非特异性症状归因于莱姆病、未将短暂的客观症状归因于莱姆病以及对莱姆病患者进行不恰当的抗生素治疗。
儿童莱姆病的诊断和治疗错误很常见。
