Lyme Disease in Children

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Abstract
The study of Lyme disease in children by Gerber et al. (Oct. 24 issue)1 describes the high rate of success when children with erythema migrans lesions are treated early with antibiotics, but it does not convey the entire picture. The authors must surely be aware that in the absence of a rash, Lyme disease can be very difficult to diagnose. What of the children who do not have a rash, or whose parents do not notice one? What of children in whom a rash is noticed but whose physicians are not familiar with it and misdiagnose it? Such cases are more prevalent than the authors suggest. In these children Lyme disease can progress to stages that include arthritic, neurologic, and cardiac complications, making treatment more difficult.

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