On 2017 Aug 20, Daniel Weiss commented:

This paper shows the insensitivity of two tiered testing for Lyme disease. Patients were “categorized as having Lyme disease, and met the CDC surveillance criteria for diagnosis”, i.e. positive serology or positive culture. Nonetheless, only “two-thirds of patients with acute neuroborreliosis or carditis … were seropositive by two-tier testing”. Therefore, one third were negative.

These authors also state that “IgM testing in Lyme disease has been problematic” and the CDC requirement that “IgM criteria should only be used to support the diagnosis of early LD in persons with illness of <1 month duration” “reduces the sensitivity of serologic testing” in certain patient groups.

This is one of many papers that argue against the reliance on serologic tests to rule out Lyme disease.

On 2017 Aug 20, Daniel Weiss commented:

This paper shows the insensitivity of two tiered testing for Lyme disease. Patients were “categorized as having Lyme disease, and met the CDC surveillance criteria for diagnosis”, i.e. positive serology or positive culture. Nonetheless, only “two-thirds of patients with acute neuroborreliosis or carditis … were seropositive by two-tier testing”. Therefore, one third were negative.

These authors also state that “IgM testing in Lyme disease has been problematic” and the CDC requirement that “IgM criteria should only be used to support the diagnosis of early LD in persons with illness of <1 month duration” “reduces the sensitivity of serologic testing” in certain patient groups.

This is one of many papers that argue against the reliance on serologic tests to rule out Lyme disease.