Sensitivity of Two-Tiered Lyme Disease Serology in Children With an Erythema Migrans Lesion

Author:

Thompson Amy D1,Balamuth Fran2,Neville Desiree N3,Chapman Laura L4,Levas Michael N5,Kharbanda Anupam B6,Branda John A7,Ladell Meagan M5,Loiselle Claire8,Nigrovic Lise E9

Affiliation:

1. Division of Emergency Medicine, Nemours Children’s Hospital and Sidney Kimmel Medical College of Thomas Jefferson University , Wilmington, Delaware , USA

2. Department of Pediatrics, Children’s Hospital of Philadelphia and University of Pennsylvania , Philadelphia, Pennsylvania , USA

3. Division of Emergency Medicine, Children’s Hospital of Pittsburgh and University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania , USA

4. Division of Pediatric Emergency Medicine, Rhode Island Hospital and Warren Alpert Medical School of Brown University , Providence, Rhode Island , USA

5. Department of Pediatric Emergency Medicine, Children’s Hospital of Wisconsin and Medical College of Wisconsin , Milwaukee, Wisconsin , USA

6. Department of Emergency Medicine, Children’s Minnesota , Minneapolis, Minnesota , USA

7. Department of Pathology, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts , USA

8. Department of Research, Nemours Children’s Hospital , Wilmington, Delaware , USA

9. Division of Emergency Medicine, Boston Children’s Hospital and Harvard Medical School , Boston, Massachusetts , USA

Abstract

Abstract In our prospective cohort of 192 children with a physician-diagnosed erythema migrans (EM) lesion, two-tier Lyme disease serology had higher sensitivity in children with multiple EM lesions (76.8% multiple lesions vs. 38.1% single EM; difference 38.7%, 95% confidence interval 24.8%–50.4%). The diagnosis of cutaneous Lyme disease should be based on careful physical examination rather than laboratory testing.

Funder

Global Lyme Alliance and Bay Area Lyme Foundation

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,General Medicine,Pediatrics, Perinatology and Child Health

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