I never considered how much living in a Lyme endemic area would influence my training as an infectious diseases fellow; in fact, I didn’t really think much about Lyme disease at all until I began getting phone call after phone call from parents and pediatricians confused about the diagnosis and treatment of Lyme disease.
The stories often start off the same: a child with non-specific constitutional symptoms, perhaps some fevers, a vague history of a rash, sometimes headaches or diffuse joint pain who just doesn’t seem like he’s getting better. Perhaps there was even an antecedent tick bite, or at the very least, a camping trip or another kid at school with Lyme disease. So, Lyme serologies are sent and whether they are positive or negative, the caller – parent or physician – is uncertain how to proceed.