Are doctors too quick to blame a tick


FARMINGTON, CONN.--Early reports about Lyme disease featured sad stories of patients trudging from doctor to doctor before someone finally recognized their ailment. Now the pendulum has swung the other way: Physicians now tend to assume that any combination of rash, muscle aches, fever, and fatigue is probably Lyme disease.

Pediatrician Henry M. Feder of the University of Connecticut Health Center examined 70 children who were diagnosed and referred to Lyme disease specialists by physicians around the state. He found that 33 kids didn't have the disease after all. Thirteen were misdiagnosed when a blood test came back falsely positive.

Twenty other children had negative blood tests, but their doctors concluded that their symptoms added up to Lyme disease anyway.

Feder says that clinicians need to be more discerning in their assessment of patients because it's easy for laboratory technicians to misinterpret the blood test used to detect Lyme disease. The consequences of an incorrect diagnosis can range from a prescription of unneeded antibiotics to failure to catch other potentially serious ailments that require treatment. Some of the children in Feder's study, for example, had eczema and one had juvenile rheumatoid arthritis.

"Usually, if it is Lyme disease, the story fits together pretty nicely," Feder says. People with Lyme disease usually have a bull's-eye rash at least 5 centimeters in diameter, along with intermittent headaches, fever, and aching muscles and joints. They are also likely to live in regions where the disease is well established. Those areas include New York, Connecticut, New Jersey, Wisconsin, and Pennsylvania.

It's worth remembering, Feder says, that a Lyme-infected tick needs to stay on the body 24 hours for a person to get infected. Checking yourself carefully after a walk in the woods can keep ticks from gaining a toehold.


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