H M Feder1, D L Whitaker. 1. Department of Pediatrics, University of Connecticut Health Center, Farmington 06030, USA.
Abstract
BACKGROUND: Erythema migrans is a clinical diagnosis that carries possible long-term repercussions. Despite widespread awareness of the clinical presentation of erythema migrans, incorrect diagnosis occurs. PATIENTS AND METHODS: We describe 13 cases in which erythema migrans was misdiagnosed and discuss some pitfalls in diagnosis. These cases were seen at a tertiary referral center in Connecticut, a state where Lyme disease is endemic. The patients selected for inclusion were those who most clearly illustrate potential difficulties involved in making the diagnosis of erythema migrans. RESULTS: The diagnosis of erythema migrans was missed in 5 patients due to atypical presentations. Eight patients with skin eruptions closely mimicking erythema migrans were incorrectly diagnosed with erythema migrans. CONCLUSIONS: There are pitfalls associated with the diagnosis of erythema migrans that may result in overdiagnosis or underdiagnosis.
BACKGROUND:Erythema migrans is a clinical diagnosis that carries possible long-term repercussions. Despite widespread awareness of the clinical presentation of erythema migrans, incorrect diagnosis occurs. PATIENTS AND METHODS: We describe 13 cases in which erythema migrans was misdiagnosed and discuss some pitfalls in diagnosis. These cases were seen at a tertiary referral center in Connecticut, a state where Lyme disease is endemic. The patients selected for inclusion were those who most clearly illustrate potential difficulties involved in making the diagnosis of erythema migrans. RESULTS: The diagnosis of erythema migrans was missed in 5 patients due to atypical presentations. Eight patients with skin eruptions closely mimicking erythema migrans were incorrectly diagnosed with erythema migrans. CONCLUSIONS: There are pitfalls associated with the diagnosis of erythema migrans that may result in overdiagnosis or underdiagnosis.
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