Lyme disease: testing and treatment. Who should be tested and treated for Lyme disease and how?

LD can mimic a number of other disease, and vice versa. It is imperative that clinicians understand LD and be able to use serologic diagnostic techniques appropriately. LD is not a diagnosis that can be made on the basis of serologic testing. By this is meant that vague symptoms plus a positive serologic test do not assure that the patient has LD. On the other hand, a patient with ECM or other manifestations of LD may still be seronegative. In addition, therapy for LD must be tailored to the clinical problems of the individual patient. Especially in patients with chronic or persisting complaints, it is important to be precise in making the correct diagnosis and in understanding the underlying pathogenetic mechanisms at work so that an appropriate and ultimately successful therapeutic plan can be made.