Resources for Clinicians
Diagnosis, Treatment and Testing
- New! – Feeling Worse After Treatment? Maybe It’s Not Lyme Disease
- 2006 IDSA Treatment Guidelines
- Two-tier testing explained
- Tests that are NOT recommended (including CD57, urine antigen testing, etc.)
- Tickborne Diseases of the United States: A Reference Manual for Health Care Providers, Third Edition (2015).
Two-tier testing for Lyme disease
About This Figure
The Two-tier Testing Decision Tree describes the steps required to properly test for Lyme disease. The first required test is the Enzyme Immunoassay (EIA) or Immunofluorescence Assay (IFA). If this test yields negative results, the provider should consider an alternative diagnosis. Or in cases where the patient has had symptoms for less than or equal to 30 days, the provider may treat the patient and follow up with a convalescent serum. If the first test yields positive or equivocal results, two options are available: 1) if the patient has had symptoms for less than or equal to 30 days, an IgM Western Blot is performed; 2) if the patient has had symptoms for more than 30 days, the IgG Western Blot is performed. The IgM should not be used if the patient has been ill for more than 30 days.
Understanding laboratory test results
About This Figure
Understanding Test Results for Infectious Diseases
The illustration depicts the likelihood of false positive and false negative test results based on the prior probability of a disease occurring in a given population. Clinicians should consider the likelihood of disease before performing laboratory testing. The likelihood that a patient has a disease depends on many factors:
- Has a patient been in an area where the disease is found?
- Does the patient have signs and symptoms typical of the disease?
- Does the patient have risk factors for contracting or developing the disease?
In populations where disease is rare or unlikely, testing is likely to lead to false positives more frequently than true positives.
Continuing Medical Education for Clinicians
- A free, CDC-sponsored Clinician Outreach and Communication Activity (COCA) course helps providers learn to properly identify and treat tickborne diseases (CME/CNE/CECH available): Tickborne Diseases: A Springtime Review of Diagnosis, Treatment and Prevention.
- As a service to clinicians, CDC has supported the development of an online CME Case Study Course on the Clinical Assessment, Treatment, and Prevention of Lyme Disease. This free, interactive course consists of a series of case studies designed to educate clinicians regarding the proper diagnosis and treatment of Lyme disease. Each case is accredited for 0.25 CME credits, for a maximum of 1.5 CME. There is no cost for these credits.
- The National Association of School Nurses presents an online course titled “Tick-borne Illness: Prevention, Assessment and Care” that focuses on clinical care of tickborne diseases in school and camp settings. CNE is available.
Lyme Disease Self Assessment
From the American College of Physicians (ACP) Initiative on Lyme Disease--an online quiz containing six clinical scenarios regarding the evaluation and treatment of Lyme disease.
Case Definition and Report Forms
- Lyme Disease Surveillance Case Definition (revised Jan 2011)
- Lyme Disease Surveillance Case Report Form [PDF - 2 pages] (for public health officials' use)
Note: Surveillance case definitions establish uniform criteria for disease reporting and should not be used as the sole criteria for establishing clinical diagnoses, determining the standard of care necessary for a particular patient, setting guidelines for quality assurance, or providing standards for reimbursement.
- Page last reviewed: March 4, 2015
- Page last updated: May 28, 2015
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