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Clinical Diagnosis of Lyme Disease Frequently Misses the "Bull's Eye".

For children with suspected Lyme disease but without a classic bull's-eye lesion (erythema migrans of at least 5 cm), check serology rather than rely on your clinical impression. In this study, 12% of the children not suspected of having Lyme disease did have Lyme disease, and 31% of children thought to have Lyme disease did not have serologic findings at that time or within 30 days.