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Review

Appropriate laboratory testing in Lyme disease

Teny M. John, MD and Alan J. Taege, MD
Cleveland Clinic Journal of Medicine November 2019, 86 (11) 751-759; DOI: https://doi.org/10.3949/ccjm.86a.19029
Teny M. John
Infectious Disease, Infection Control and Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX
Roles: Assistant Professor
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Alan J. Taege
Department of Infectious Disease, Cleveland Clinic; Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
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ABSTRACT

Testing for Lyme disease is challenging and if done incorrectly can lead to unnecessary treatment. To interpret serologic test results, first assess the patient’s pretest probability of infection based on the probability of exposure and clinical findings. Two-tiered testing remains the gold standard in diagnosing Lyme disease, although new guidelines may be published soon.

  • © 2019 The Cleveland Clinic Foundation. All Rights Reserved.
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  1. Teny M. John, MD, Assistant Professor
  1. Infectious Disease, Infection Control and Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX
  1. Alan J. Taege, MD⇑
  1. Department of Infectious Disease, Cleveland Clinic; Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
  1. ADDRESS:
    Alan J. Taege, MD, Department of Infectious Disease, G21, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH; taegea{at}ccf.org

ABSTRACT

Testing for Lyme disease is challenging and if done incorrectly can lead to unnecessary treatment. To interpret serologic test results, first assess the patient’s pretest probability of infection based on the probability of exposure and clinical findings. Two-tiered testing remains the gold standard in diagnosing Lyme disease, although new guidelines may be published soon.

  • © 2019 The Cleveland Clinic Foundation. All Rights Reserved.
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Cleveland Clinic Journal of Medicine: 86 (11)
Cleveland Clinic Journal of Medicine
Vol. 86, Issue 11
1 Nov 2019
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Appropriate laboratory testing in Lyme disease
Teny M. John, Alan J. Taege
Cleveland Clinic Journal of Medicine Nov 2019, 86 (11) 751-759; DOI: 10.3949/ccjm.86a.19029

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Appropriate laboratory testing in Lyme disease
Teny M. John, Alan J. Taege
Cleveland Clinic Journal of Medicine Nov 2019, 86 (11) 751-759; DOI: 10.3949/ccjm.86a.19029
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  • Article
    • ABSTRACT
    • THE MOST COMMON TICK-BORNE INFECTION IN NORTH AMERICA
    • FIRST COMES IgM, THEN IgG
    • LYME DISEASE EVOLVES THROUGH STAGES
    • INTERPRET LABORATORY RESULTS BASED ON PRETEST PROBABILITY
    • DIRECT METHODS
    • INDIRECT METHODS
    • RECOMMENDATIONS FOR TESTING
    • DIAGNOSIS IN SPECIAL SITUATIONS
    • ACKNOWLEDGMENT
    • References
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  • PDF

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