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Review

Laboratory Diagnosis of Lyme Borreliosis

John A. Branda, Allen C. Steere
John A. Branda
aDepartment of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Allen C. Steere
bDepartment of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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DOI: 10.1128/CMR.00018-19
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SUMMARY

Lyme borreliosis is caused by a growing list of related, yet distinct, spirochetes with complex biology and sophisticated immune evasion mechanisms. It may result in a range of clinical manifestations involving different organ systems, and can lead to persistent sequelae in a subset of cases. The pathogenesis of Lyme borreliosis is incompletely understood, and laboratory diagnosis, the focus of this review, requires considerable understanding to interpret the results correctly. Direct detection of the infectious agent is usually not possible or practical, necessitating a continued reliance on serologic testing. Still, some important advances have been made in the area of diagnostics, and there are many promising ideas for future assay development. This review summarizes the state of the art in laboratory diagnostics for Lyme borreliosis, provides guidance in test selection and interpretation, and highlights future directions.

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Laboratory Diagnosis of Lyme Borreliosis
John A. Branda, Allen C. Steere
Clinical Microbiology Reviews Jan 2021, 34 (2) e00018-19; DOI: 10.1128/CMR.00018-19

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Laboratory Diagnosis of Lyme Borreliosis
John A. Branda, Allen C. Steere
Clinical Microbiology Reviews Jan 2021, 34 (2) e00018-19; DOI: 10.1128/CMR.00018-19
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  • Top
  • Article
    • SUMMARY
    • INTRODUCTION
    • AGENTS OF INFECTION
    • TRANSMISSION, EPIDEMIOLOGY, AND RISK FACTORS
    • CLINICAL MANIFESTATIONS
    • DIAGNOSTIC TESTING
    • TEST SELECTION AND INTERPRETATION IN CLINICAL PRACTICE
    • OUTLOOKS
    • ACKNOWLEDGMENTS
    • REFERENCES
    • Author Bios
  • Figures & Data
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  • PDF

KEYWORDS

Borrelia
Borrelia burgdorferi
Borreliella
borreliosis
diagnosis
diagnostics
Lyme Disease
molecular methods
serology

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