Lyme disease: a diagnostic dilemma
The Nurse Practitioner
Nurse Pract. 2010 Jul;35(7):44-50
It is impossible to know the true prevalence of Lyme disease (LD), a bacterial illness transmitted through the bite of a tiny deer tick. Many cases go undiagnosed and the CDC admits that the disease is probably underreported tenfold. LD is caused by the bacterium Borrelia burgdorferi, a genetically sophisticated sphirochete with stealth pathology and numerous methods of immune system evasion. Like its close spirochetal cousin Treponeima Pallidrum (the bacterium that causes syphilis) B.burgdorferi can cause disabling neurological manifestations and present a puzzling diagnostic challenge. Because the disease is often missed in its early stages when treatment is most successful, years of needless morbidity and and disability ensue for thousands of patients. This article presents the diagnostic challenges inherent in the diagnosis of LD and provides information about when to suspect LD and how to test for it.