Difficulties with Lyme serology

Lyme disease is a multisystem infection characterized by dermatologic, neurologic, and arthritic findings. Like syphilis, Lyme borreliosis may imitate several other infectious and non-infectious diseases. Diagnosis is dependent on a reliable history (if available), clinical findings, and blood serology findings. A major problem has been seronegativity in persons possessing the disease (false negatives). At present, seronegativity in persons strongly suspected of having Lyme disease does not necessarily exclude the diagnosis of Lyme disease. The clinician must recognize this in patients who may have Lyme disease or a recurrence of the disease.