Comment; Unsuprising but a great reminder that we need to keep a high index of suspicion for testing even with a thorough medical history!
by Daniel J. Cameron, MD, MPH
The study looked at 325 children with Lyme disease who were evaluated at six different emergency medicine departments located in Lyme endemic regions. The patients all had an available tick bite history.
“Our goal was to report the frequency of a known tick bite in children with Lyme disease overall and by stage,” the authors explain.Study finds, only 18.5% of children with Lyme disease recall a tick bite.CLICK TO TWEET
The children were diagnosed with Lyme disease based upon the presence of an erythema migrans (bull’s-eye) rash or a positive or equivocal C6 EIA followed by a positive immunoblot.
The authors found that only a minority (18.5%) of the children recalled a tick bite preceding their illness. “We demonstrate that lack of tick bite history does not reliably exclude the possibility of Lyme disease for children from endemic areas,” the authors write.
The takeaway message of this study? Don’t count on seeing a tick bite in children with Lyme disease.
- Nigrovic LE, Neville DN, Balamuth F, et al. A minority of children diagnosed with Lyme disease recall a preceding tick bite. Ticks Tick Borne Dis. 2019.