Journal of the Formosan Medical Association
Volume 106, Issue 7 , Pages 577-581, 2007

Erythema Migrans Mimicking Cervical Cellulitis with Deep Neck Infection in a Child with Lyme Disease

  • Tsung-Han Li

      Affiliations

    • Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
    • Department of Pediatrics, Hualien Armed Forces General Hospital, Hualien, Taipei, Taiwan
    • ,
  • Chien-Ming Shih

      Affiliations

    • Department of Parasitology and Tropical Medicine, National Defense Medical Center, Taipei, Taiwan
    • ,
  • Wei-Jen Lin

      Affiliations

    • Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
    • ,
  • Chien-Wei Lu

      Affiliations

    • Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
    • ,
  • Li-Lian Chao

      Affiliations

    • Department of Parasitology and Tropical Medicine, National Defense Medical Center, Taipei, Taiwan
    • ,
  • Chih-Chien Wang

      Affiliations

    • Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Chih-Chien Wang, Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, 325 Cheng-Kung Road, Section 2, Neihu, Taipei 114, Taiwan

Received 10 March 2006; received in revised form 19 June 2006; accepted 2 January 2007.

Article Outline

In the early stage of Lyme disease, atypical lesions of erythema migrans rash can develop and extend over the neck region, mimicking cervical cellulitis with deep neck infection. Here, we report a 9-year-old Taiwanese boy with a recent history of exposure to deer during his visit to Nanto County in central Taiwan. Cervical cellulitis with lymphadenitis was initially diagnosed. Erythema migrans developed in the following days and Lyme disease was finally diagnosed by a Western immunoblot test. Alertness to this unique clinical feature is required for prompt differential diagnosis of Lyme disease with a presentation of erythema migrans mimicking cervical cellulitis.

Key Words:  cervical cellulitis , childhood , erythema migrans , Lyme disease

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PII: S0929-6646(07)60009-6

doi:10.1016/S0929-6646(07)60009-6

Journal of the Formosan Medical Association
Volume 106, Issue 7 , Pages 577-581, 2007

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