3 ms·

Your son, like most people who get Lyme, probably had a bulls-eye rash and/or recalled being bitten by a tick. A bulls-eye rash is enough to diagnose Lyme disea

by __z 11y ago

Your son, like most people who get Lyme, probably had a bulls-eye rash and/or recalled being bitten by a tick. A bulls-eye rash is enough to diagnose Lyme disease. Not only that if you start coming down with symptoms of Lyme right after getting bitten by a tick then diagnosis is very trivial. Those who don't have a bulls-eye rash or recollection of tick bites and don't spend a lot of time in the woods have non-specific symptoms such as fatigue and joint pain. Those are the cases that the diagnosis can very easily be missed. Nowadays Lyme is so common around here that anyone complaining of any non-specific symptoms gets a Lyme blood test. 10 years ago that was probably not the case. A friend of mine went to the doctor with non-specific symptoms and tested positive for Lyme. If her doctors didn't run the Lyme test they would have missed it. They ran the Lyme test even though she didn't spend any time in the woods or remembered any tick bites because they now know to. If Lyme isn't on the radar of doctors that is a huge problem for diagnosis of some cases. It probably would especially suck for someone who lives in, say, Utah who went to vacation in Maine and didn't recall a tick bite. Your average Utah doctor has probably never even seen a patient with Lyme disease and probably won't think to check for it or ask if you've traveled somewhere where Lyme is common. Source: http://www.cdc.gov/lyme/stats/chartstables/reportedcases_statelocality.html http://www.cdc.gov/lyme/stats/chartstables/reportedcases_sta...

thomnottom 11y ago
Unfortunately, that's not the case in all areas where Lyme is prevalent. On top of that, the standard Lyme test is not very reliable. Living in New Jersey (filled with deer, mice, and ticks) you would think that doctors would be more aware. But it took several different doctors, emergency visits, hospitalizations, and, yes, a negative Lyme test before my wife was finally diagnosed. The standard reply in the hospital was that even though they had no clue what was wrong with my wife, they were certain that it wasn't Lyme. And since insurance doesn't cover the Igenix tests, we had to pay the $300+ out of pocket.
- tomkinstinch 11y ago
  Like you said, the standard Lyme test is not very reliable. Even if laboratory tests are ordered, labs are still using immunoassays for confirmation of Lyme (ELISA, then a Western Blot), which have relatively poor sensitivity (~70% or lower[1]) due to low serum concentration of Borrelia or possible absence of antibodies—so they can miss one in four true-positive cases. The newer PCR-based assays have much better sensitivity (>70%, maybe closer to 90%[2]), but the assays are not yet in widespread use, are still being proven, and thus are seen only as adjuncts to immunoassays that can provide further evidence of Lyme. It can also take a couple weeks from when the bullseye rash appears (or when the tick bite occurs) for serology to test positive, again due to the Borrelia/antibody concentration being below the limit of detection. Samples tested are also usually blood, which may not be as good as CSF. It's a tricky bug to diagnose in the laboratory, which is why it comes down to the discretion of the clinician and the doctor's knowledge of the patient and his or her history. 1. http://www.igenex.com/files/should_know.pdf http://www.igenex.com/files/should_know.pdf 2. Laboratory Diagnostic Testing for Borrelia burgdorferi Infection, Lyme Disease: An Evidence-based Approach: http://www.cdc.gov/lyme/resources/Halperin_2012_Chap4_JohnsonB.pdf http://www.cdc.gov/lyme/resources/Halperin_2012_Chap4_Johnso...

by __z 11y ago

thomnottom 11y ago

Unfortunately, that's not the case in all areas where Lyme is prevalent. On top of that, the standard Lyme test is not very reliable. Living in New Jersey (filled with deer, mice, and ticks) you would think that doctors would be more aware. But it took several different doctors, emergency visits, hospitalizations, and, yes, a negative Lyme test before my wife was finally diagnosed. The standard reply in the hospital was that even though they had no clue what was wrong with my wife, they were certain that it wasn't Lyme. And since insurance doesn't cover the Igenix tests, we had to pay the $300+ out of pocket.

tomkinstinch 11y ago
Like you said, the standard Lyme test is not very reliable. Even if laboratory tests are ordered, labs are still using immunoassays for confirmation of Lyme (ELISA, then a Western Blot), which have relatively poor sensitivity (~70% or lower[1]) due to low serum concentration of Borrelia or possible absence of antibodies—so they can miss one in four true-positive cases. The newer PCR-based assays have much better sensitivity (>70%, maybe closer to 90%[2]), but the assays are not yet in widespread use, are still being proven, and thus are seen only as adjuncts to immunoassays that can provide further evidence of Lyme. It can also take a couple weeks from when the bullseye rash appears (or when the tick bite occurs) for serology to test positive, again due to the Borrelia/antibody concentration being below the limit of detection. Samples tested are also usually blood, which may not be as good as CSF. It's a tricky bug to diagnose in the laboratory, which is why it comes down to the discretion of the clinician and the doctor's knowledge of the patient and his or her history. 1. http://www.igenex.com/files/should_know.pdf http://www.igenex.com/files/should_know.pdf 2. Laboratory Diagnostic Testing for Borrelia burgdorferi Infection, Lyme Disease: An Evidence-based Approach: http://www.cdc.gov/lyme/resources/Halperin_2012_Chap4_JohnsonB.pdf http://www.cdc.gov/lyme/resources/Halperin_2012_Chap4_Johnso...