Guidelines for the Clinical Diagnosis of Lyme Disease
Authors: Kenneth B. Liegner
Journal: Annals of Internal Medicine (1998)

Letters1 September 1998Guidelines for the Clinical Diagnosis of Lyme DiseaseKenneth B. Liegner, MD and Janice Kochevar, FNPKenneth B. Liegner, MDArmonk, NY 1054Search for more papers by this author and Janice Kochevar, FNPArmonk, NY 1054Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-5-199809010-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The American College of Physicians' position paper on Lyme disease [1] ignores the serious problem of false-negative test results, thereby promoting continuation of circular reasoning in the diagnosis of this illness. Delay in diagnosis and application of treatment because of overreliance on the diagnostic criteria and therapeutic approach promoted by the position paper has resulted in advanced neurologic injury, debility, and death [2].A review of simultaneous enzyme-linked immunosorbent assay (ELISA) and Western blotting in our practice, which specializes in Lyme disease, showed that 16% of patients had concurrent positive test results but that 21% had fully ...References1. Guidelines for laboratory evaluation in the diagnosis of Lyme disease. American College of Physicians. Ann Intern Med. 1997; 127:1106-8. Google Scholar2. Liegner KB, Duray PH, Agricola M, Rosenkilde C, Yannuzzi L, Ziska M, et al. Lyme disease and the clinical spectrum of antibiotic-responsive chronic meningoencephalomyelitides. Journal of Spirochetal and Tick-borne Diseases. [In press.] Google Scholar3. Kochevar JM, Liegner KB. Simultaneous ELISA and Western blot testing in evaluation of patients for suspected Lyme disease [Abstract]. Proceedings of Lyme Disease Foundation X Annual Scientific Conference on Lyme Borreliosis and Other Tick-borne Disorders. Bethesda, MD; 1997. Google Scholar4. Liegner KB, Rosenkilde CE, Campbell GL, Quan TJ, Dennis DT. Culture-confirmed treatment failure of cefotaxime and minocycline in a case of Lyme meningoencephalomyelitis in the United States [Abstract]. Proceedings of V International Conference on Lyme Disease. Arlington, Va.; 1992. Google Scholar5. Preac-Mursic V, Weber K, Pfister HW, Wilske B, Gross B, Baumann A, et al. Survival of Borrelia burgdorferi in antibiotically treated patients with Lyme borreliosis. Infection. 1989; 17:355-9. Google Scholar Author, Article, and Disclosure InformationAuthors: Kenneth B. Liegner, MD; Janice Kochevar, FNPAffiliations: Armonk, NY 1054 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoExhaled Nitric Oxide and Impaired Oxygenation in Cirrhotic Patients before and after Liver Transplantation Giovanni Rolla , Luisa Brussino , Paola Colagrande , Ermanno Scappaticci , Mara Morello , Serena Bergerone , Antonio Ottobrelli , Elisabetta Cerutti , Salvatore Polizzi , and Caterina Bucca Metrics Cited byCounterpoint: Long-Term Antibiotic Therapy Improves Persistent Symptoms Associated with Lyme DiseaseLyme disease: point/counterpointTreatment of Lyme disease: a medicolegal assessmentThe Lyme Wars: time to listenRoutine diagnosis of Borrelia burgdorferi (sensu lato) infections using a real-time PCR assayDecreased CD57 lymphocyte subset in patients with chronic Lyme diseaseDeath from Inappropriate Therapy for Lyme Disease 1 September 1998Volume 129, Issue 5 Page: 422 Keywords Enzyme linked immunosorbent assay Falls HIV infections Lyme disease Patients Reasoning Western blot ePublished: 15 August 2000 Issue Published: 1 September 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...