Lyme Disease

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Quick GuideLyme Disease Symptoms, Rash, Treatments

Lyme Disease Symptoms, Rash, Treatments

What tests do health-care professionals use to diagnose Lyme disease?

In early Lyme disease, doctors can sometimes make a diagnosis simply by finding the classic red rash (described above), particularly in people who have recently been in regions in which Lyme disease is common. The doctor might review the patient's history and examine the patient in order to exclude diseases with similar findings in the joints, heart, and nervous system.

Blood testing for antibodies to Lyme bacteria is generally not necessary or helpful in early stage disease, but it can help in diagnosis in later stages. (Antibodies are produced by the body to attack the bacteria and can be evidence of exposure to the bacteria. These antibodies can be detected using a laboratory method called an enzyme-linked immunosorbent assay [ELISA].) Antibodies, however, can be false indicators of disease, since they can persist for years after the disease is cured. Moreover, false-positive tests in patients with nonspecific findings (those that are not specifically suggestive of Lyme disease) can lead to confusion. Currently, the confirmatory test that is most reliable is the Western Blot assay antibody test. More accurate tests are being developed. Both the ELISA test and the Western Blot tests are analyses of blood samples to test for Lyme disease.

Generally, Lyme blood testing is helpful in a patient who has symptoms compatible with Lyme disease, who has a history of a tick bite at least a month prior, or who has unexplained disorders of the heart, joints, or nervous system that are characteristic of Lyme disease.

Reviewed on 4/7/2016
References
REFERENCES:

Berende, Anneleen, et al. "Randomized Trial of Longer-Term Therapy for Symptoms Attributed to Lyme Disease." N Engl J Med 374 (2016): 1209-20.

Klippel, John H., et al., eds. Primer on the Rheumatic Diseases. 13th ed. New York: Springer and Arthritis Foundation, 2008.

Shapiro, E.D. "Lyme Disease." N Engl J Med 370.18 (2014): 1724-1731.

IMAGES:

1.CDC - James Gathany

2.iStock

3.iStock

4.CDC

5.Interactive Medical Media LLC. All rights reserved./"Bullseye Lyme Disease Rash" by Hannah Garrison

6.iStock

7.Comstock Images/Getty Images

8.Getty Images/MedicineNet/iStock

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