A subject dear to my heart. My 5 year old was diagnosed 2 weeks ago with lyme. To complicate things, she has rheumatoid arthritis.
The doctors refused to admit it could be lyme - blamed all the pain and rash on her arthritis!
Her rheumatologists didn't even want to see her since she didn't have any red swollen joints. Just kept having me take her back to her pediatrician.
It took 4 visits (the last two of which she was showing the classic bullseye rash) before I saw a pediatrician who would treat her for lyme. By that point she couldn't walk from the pain. 4 days later the blood work came back positive.
Sorry for the venting, but that was several of the most frustrating, stressful weeks I've had in a long time! It took a lot of self control not to grab the pediatrician and scream "JUST GIVE ME THE ANTIBIOTIC!" Moral adherence to the mantra of no antibiotic without a positive titer is all well and good except when all clinical signs point to lyme and your patient is immune supressed and in debilitating pain. Time to get off your high horse and start treatment at that point. IMNSHO.
ps - She's doing much better now. In fact 2 days after starting the antibiotic, she was back on her feet. Now she is back to insisting she is going to be an acrobat when she grows up
pps - In the doctors' defense, she did have some sort of viral thing going on at the same time which complicated the diagnosis.