Emergency and critical care pediatricsLyme disease updateHoppa, Eric; Bachur, Richard Author Information Division of Emergency Medicine, Children's Hospital, Boston, Massachusetts, USA Correspondence to Eric Hoppa, MD, Division of Emergency Medicine, 300 Longwood Avenue, Boston, MA 02115, USA Tel: +1 617 355 6624; e-mail: [email protected] Current Opinion in Pediatrics: June 2007 - Volume 19 - Issue 3 - p 275-280 doi: 10.1097/MOP.0b013e3280e1269a Buy Metrics Abstract Purpose of review Lyme disease is endemic to areas in both Europe and the United States and the incidence is increasing. Despite published guidelines, controversy persists about its diagnosis and management in patients who do not meet strict diagnostic criteria. This review summarizes important recently published studies and recommendations for the diagnosis and management of Lyme disease. Recent findings Recent comprehensive guidelines have been published for the diagnosis and management of pediatric Lyme disease. In addition, recent studies may help physicians differentiate between Lyme and aseptic meningitis, as well as show the poor sensitivity of cerebrospinal fluid polymerase chain reaction. Controversy continues about the diagnosis and management of ‘chronic Lyme disease’, despite the current medical literature. Recently published studies in the US have also better described southern tick-associated rash illness, an entity that may present a similar clinical picture to Lyme disease. Guidelines have also been published on the management and diagnosis of other tick-borne illnesses often seen as co-infections with Lyme disease. Finally, case reports have been published describing new cardiac manifestations associated with Lyme disease. Summary Controversies persist about the diagnosis and management of Lyme disease. Recently published guidelines and primary research can aid clinicians in diagnosing Lyme properly. © 2007 Lippincott Williams & Wilkins, Inc.