NYMC Faculty Publications

Lyme Disease: Diagnostic Issues and Controversies

Author Type(s)

Faculty

DOI

10.1586/14737159.2015.989837

Journal Title

Expert Review of Molecular Diagnostics

First Page

1

Last Page

4

Document Type

Article

Publication Date

1-1-2015

Department

Pathology, Microbiology and Immunology

Second Department

Pharmacology

Keywords

Animals, Antibodies, Bacterial, Borrelia burgdorferi, Diagnostic Errors, Humans, Lyme Disease

Disciplines

Medicine and Health Sciences

Abstract

The diagnosis of Lyme disease is a controversial topic. Most practitioners and scientists recognize that Lyme disease is associated with certain objective clinical manifestations supported by laboratory evidence of infection with Borrelia burgdorferi sensu lato (the etiologic agent). There are others, however, who believe that patients with Lyme disease may have a wide variety of entirely nonspecific symptoms without any objective clinical manifestation and that laboratory evidence of infection by B. burgdorferi is not required to support the diagnosis. In reality, this perspective is not evidence based and would inevitably lead to innumerable misdiagnoses, given the high frequency of medically unexplained symptoms, such as fatigue and musculoskeletal pains, in the general population. Although those espousing this viewpoint do not believe that a positive laboratory test is required, nevertheless, they often seek out and promote alternative, unapproved testing methods that frequently provide false-positive results to justify their diagnosis. Herein, we provide a brief overview of Lyme disease testing, emphasizing current usage and limitations. We also discuss the use of nonvalidated procedures and the prospects for a reduction in such testing practices in the future.

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