Tick-borneinfectionsthatpredominateintheU.S.include.pptVIP

Lyme Disease – DiagnosisBased clinical findings, exposure risk, laboratory studies Issues with Lyme Serology Standardization False positives Other borrelial infections and spirochetal diseases, viral illness, autoimmune disease, cross-reactions due to intestinal commensals and gram negative UTI pathogens 5% of normal population will test positive by ELISA Low sensitivity in early disease Up to 6 – 8 week seronegative window Serology 20 –30% sensitive during EM, 70-80% on repeat Co-infection with B. microti or A. phagocytophilum may occur The vast majority of patients with early disseminated