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Why Is It So Hard to Get a Lyme Disease Diagnosis
Due to the wide range of symptoms, the need for more specificity, and the potential for false negative results in diagnostic tests, Lyme disease can be tricky to diagnose. If the tick bite is forgotten or the tick itself cannot be located, it can be challenging to determine where the infection originated.
Jan 07, 2023 By Nancy Miller

The bacterium Borrelia burgdorferi, which causes Lyme disease, is transmitted to humans through the bite of infected ticks. Even though lyme disease diagnosis is easily treatable with antibiotics, it is often misdiagnosed because its symptoms are nonspecific, and the diagnostic tests often give false negative results. Lyme disease symptoms can be quite diverse and may not manifest for weeks after the initial tick bite. Most people notice a rash at the tick bite site called erythema migrans about a week after the edge. Untreated, the infection can spread to other body parts and cause serious complications. Blood tests looking for antibodies to Borrelia burgdorferi may be used by doctors in conjunction with the patient's medical history, symptoms, and tick exposure risk to diagnose Lyme disease.

Symptoms

Lyme disease symptoms can vary from person to person and may not show up for weeks after a tick bite. The most typical sign is a red, itchy rash called erythema migrans at the bite site about a week after the tick bite. Circular in shape, the inflammation may also cause fever, headache, and extreme exhaustion. The condition could worsen if the infection spreads to other body parts. Pain and swelling in the joints (Lyme arthritis), issues with the nervous system, and even heart problems are all possible side effects of this infectious disease.

Diagnostic Tests of Lyme Disease

The patient's medical history, symptoms, and risk of exposure to ticks may all be taken into account by doctors when making a diagnosis of Lyme disease. They may also check for Borrelia burgdorferi antibodies in the blood. Lyme disease can be diagnosed with either an enzyme-linked immunosorbent assay (ELISA) or a Western blot of the blood. Checking for Borrelia burgdorferi antibodies can be done with an ELISA test. Western blotting is typically used to confirm a diagnosis after an ELISA test returns positive. However, these tests can provide false negative results in the early stages of infection. This means that one may have Lyme disease despite a negative test result. A negative test result in the later stages of the disease may not necessarily mean that the person does not have the infection because the sensitivity of the tests decreases over time.

Factors That Complicate Diagnosis Of Lyme Disease

Diagnosis of Lyme disease can be made more difficult by several factors:

  • The incubation period for Lyme disease varies widely, from a few days to several weeks, so it may be some time before symptoms appear after a tick bite. As a result, it may take weeks, if not months, to associate the tick bite with the onset of symptoms.
  • The symptoms may lack specificity: Lyme disease is often misdiagnosed because its symptoms are similar to the common cold.
  • Occasionally, negative test results can be a false alarm: It was previously mentioned that Lyme disease diagnostic tests, mainly when used early in the course of an infection, can give false negative results.
  • Having a tick bite may not be something you think about: Tick bite victims often don't realize they were bitten, complicating efforts to trace infections back to their initial source.
  • It can be challenging to confirm a diagnosis if the tick that transmitted the disease cannot be located.
  • Lyme disease is most common in some areas of the United States, Europe, and Asia, but it is not universally recognized as an infection elsewhere. Lack of awareness of the disease in some regions may delay diagnosis and treatment.

Misconceptions About Lyme Disease

Misconceptions about Lyme disease add another layer of difficulty to the diagnostic process and the subsequent treatment. Some people think Lyme disease is only spread by ticks in certain parts of the United States, that the telltale erythema migrans rash always appears, and that a negative test result means that the person does not have the infection. Some people with Lyme disease may experience symptoms after being treated with antibiotics for a few weeks, dispelling another common myth about the disease.

Conclusion

Due to the wide range of symptoms, the need for more specificity, and the potential for false negative results in diagnostic tests, Lyme disease can be tricky to diagnose. When diagnosing, providers must consider the patient's medical history, symptoms, and tick exposure risk. For this reason, people must take precautions against getting bitten by ticks and get medical help immediately if they suspect they have been bitten.