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Diagnosis of Lyme Disease

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Lyme disease is the most common tick-borne illness in the US, occurring predominantly in the Northeast, the upper Midwest, and Northern California, with increasing incidence and geographic range.1 Lyme disease can cause a skin lesion at the site of the initial tick bite as well as disseminated disease, including neuropathy, meningitis, acute myocarditis/pericarditis (often with associated conduction abnormalities), and arthritis. Accurate diagnosis is the first step in the optimal management of Lyme disease.

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Article Information

Corresponding Author: Adam S. Cifu, MD, University of Chicago, 5841 S Maryland Ave, MC 3051, Chicago, IL 60637 (adamcifu@uchicago.edu).

Conflict of Interest Disclosures: None reported.

References
1.
Centers for Disease Control and Prevention. Lyme disease—confirmed cases by month of disease onset, United States, 2001-2017. Accessed January 24, 2022. https://cdc.gov/lyme/stats/graphs.html
2.
Lantos  PM , Rumbaugh  J , Bockenstedt  LK ,  et al.  2020 guidelines for the prevention, diagnosis and treatment of Lyme disease.   Clin Infect Dis. 2021;72(1):e1-e48. doi:10.1093/cid/ciaa1215PubMedGoogle ScholarCrossref
3.
Steere  AC , McHugh  G , Damle  N , Sikand  VK .  Prospective study of serologic tests for Lyme disease.   Clin Infect Dis. 2008;47(2):188-195. doi:10.1086/589242PubMedGoogle ScholarCrossref
4.
Molins  CR , Delorey  MJ , Sexton  C , Schriefer  ME .  Lyme borreliosis serology: performance of several commonly used laboratory diagnostic tests and a large resource panel of well-characterized patient samples.   J Clin Microbiol. 2016;54(11):2726-2734. doi:10.1128/JCM.00874-16PubMedGoogle ScholarCrossref
5.
Mead  P , Petersen  J , Hinckley  A .  Updated CDC recommendation for serologic diagnosis of Lyme disease.   MMWR Morb Mortal Wkly Rep. 2019;68(32):703. doi:10.15585/mmwr.mm6832a4PubMedGoogle ScholarCrossref
6.
Centers for Disease Control and Prevention.  Recommendations for test performance and interpretation from the second National Conference on Serologic Diagnosis of Lyme Disease.   MMWR Morb Mortal Wkly Rep. 1995;44(31):590-591.PubMedGoogle Scholar
7.
Steere  AC , Berardi  VP , Weeks  KE , Logigian  EL , Ackermann  R .  Evaluation of the intrathecal antibody response to Borrelia burgdorferi as a diagnostic test for Lyme neuroborreliosis.   J Infect Dis. 1990;161(6):1203-1209. doi:10.1093/infdis/161.6.1203PubMedGoogle ScholarCrossref
8.
Halperin  JJ , Volkman  DJ , Wu  P .  Central nervous system abnormalities in Lyme neuroborreliosis.   Neurology. 1991;41(10):1571-1582. doi:10.1212/WNL.41.10.1571PubMedGoogle ScholarCrossref
9.
Branda  JA , Steere  AC .  Laboratory diagnosis of Lyme borreliosis.   Clin Microbiol Rev. 2021;34(2):e00018-e00019. doi:10.1128/CMR.00018-19PubMedGoogle ScholarCrossref
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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