Anchoring Bias, Lyme Disease, and the Diagnosis Conundrum.

anchoring bias borrelia false positive immunoblot lyme disease tickborne diseases ticks

Journal

Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737

Informations de publication

Date de publication:
22 Mar 2019
Historique:
entrez: 12 6 2019
pubmed: 12 6 2019
medline: 12 6 2019
Statut: epublish

Résumé

Lyme disease remains the most common vector-borne disease in North America. This academic teaching case highlights a full diagnostic workup fueled by anchoring bias, resulting in a presumptive diagnosis of early disseminated Lyme meningitis. Patient report of direct tick exposure, neurocranial defects, and equivocal serologies, despite geographic region of low pretest probability, confounded the clinical picture. Infectious workup confirmed the true diagnosis to be aseptic meningitis due to enterovirus. This clinical vignette acknowledges the habitual anchoring biases in the daily decision-making among internists and trainees contributing to misdiagnoses and subsequently, overtreatment.

Identifiants

pubmed: 31183280
doi: 10.7759/cureus.4300
pmc: PMC6538114
doi:

Types de publication

Case Reports

Langues

eng

Pagination

e4300

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Références

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Arch Intern Med. 1996 Jul 22;156(14):1493-500
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Arch Intern Med. 1996 Oct 14;156(18):2105-9
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Auteurs

Luis E Aguirre (LE)

Internal Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, USA.

Teresa Chueng (T)

Internal Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, USA.

Marco Lorio (M)

Internal Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, USA.

Michael Mueller (M)

Internal Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, USA.

Classifications MeSH