BILIARY COMPLICATIONS IN THE TREATMENT OF UNSUBSTANTIATED LYME-DISEASE

Treatment of unsubstantiated Lyme disease has led to serious complicat ions in some cases. Two case-control studies, based on information in clinical records of patients discharged with a diagnosis of Lyme disea se during 1990-1992, were conducted at a central New Jersey hospital. Twenty-five patients with biliary disease were identified, and 52 cont rols were selected from 1352 patients with suspected Lyme disease. Onl y 3% of 71 evaluatable subjects met the study criteria for disseminate d Lyme disease. Patients with biliary disease were more likely than we re antibiotic controls to have received ceftriaxone and more likely th an ceftriaxone controls to have received a daily ceftriaxone dose grea ter than or equal to 40 mg/kg and to be less than or equal to 18 years old, Fourteen of 25 biliary case-patients underwent cholecystectomy; all had histopathologic evidence of cholecystitis and 12 had gallstone s. Thus, treatment of unsubstantiated diagnoses of Lyme disease is ass ociated with biliary complications.