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Diagnosis of Lyme disease

Linden Hu, MD
Section Editor
Allen C Steere, MD
Deputy Editor
Jennifer Mitty, MD, MPH


Lyme disease is the most common tick-borne disease in the United States, Canada, and Europe [1-3]. It is a bacterial infection caused by six species in the spirochete family Borreliaceae. The taxonomy of these spirochetes is undergoing revision, and the genus name may be represented as either Borrelia or Borreliella. In either case, the abbreviation for the genus is "B" and stands for both terminologies in the discussion below.

In North America, infection is caused primarily by B. burgdorferi and, less commonly, in a region of the upper mid-West, by B. mayonii. In Europe and Asia, infection is caused primarily by either B. afzelii or B. garinii, less commonly by B. burgdorferi, and rarely by B. spielmanii or B. bavariensis. There is a broad spectrum of manifestations, and severity of disease is due, in part, to differences in the infecting species.

The diagnosis of Lyme disease will be reviewed here. Specific considerations regarding the diagnosis of Lyme arthritis and neurologic Lyme disease, as well as topic reviews that discuss the microbiology, epidemiology, immunopathogenesis, clinical manifestations, treatment, and prevention of Lyme disease, are presented elsewhere.

(See "Musculoskeletal manifestations of Lyme disease", section on 'Laboratory testing'.)

(See "Nervous system Lyme disease", section on 'Diagnosis'.)

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Literature review current through: Oct 2017. | This topic last updated: May 09, 2017.
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