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Diagnostic Tests for Lyme Disease

Henry M. Feder Jr, MD; Kathryn E. Rosenthal, MD
JAMA. 1990;264(6):693. doi:10.1001/jama.1990.03450060038015.
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To the Editor.—  In their recent study, Schwartz and colleagues1 emphasized the variability of results using standard antibody tests for Borrelia burgdorferi, the agent of Lyme disease. In addition to the standard antibody tests there are experimental Lyme disease tests that may give misleading results.

Report of a Case.—  A 36-year-old woman was hospitalized because of fever and neutropenia that occurred following cefotaxime therapy for presumed Lyme disease. In 1988 the patient developed diffuse muscle and joint pains. Findings from physical examination and laboratory studies, including an enzyme-linked immunosorbent assay (ELISA) for antibodies to B burgdorferi, were negative. The patient lived in an area endemic for Lyme disease and believed that her symptoms were due to Lyme disease.An empiric 21-day course of penicillin V (500 mg four times daily) was prescribed. Her symptoms continued, and she was referred to a rheumatologist, who found no objective finding consistent with


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