Diagnosis of Lyme Disease

The diagnosis of Lyme disease is not always easily made. As the lyme bacteria does not have a specific target in the body, a clinical diagnosis may not be readily apparent. In fact, a Bull's Eye (erythema migrans) rash is the only true clinical symptom of Lyme disease. Many other diseases can give symptoms that are similar to Lyme disease. Therefore when trying to determine the cause of your symptoms, consideration must be given to other disease states that Lyme disease can mimic.


Bull's Eye (Erythema Migrans) Rash

With permission of the LDF


The Bull's Eye (erythema migrans) rash occurs 3-30 days after a tick bite, at the site of the bite. While some experts once believed that if you did not have a Bull's Eye (erythema migrans) rash you could not have Lyme disease, they now readily accept that not all patients with Lyme disease will have a Bull's Eye (erythema migrans) rash. Experience has shown that less than one in three patients have had a Bull's Eye (erythema migrans) rash. If you have a Bull's Eye (erythema migrans) rash, you need immediate treatment, no further laboratory testing is necessary.


If you are do not currently have an Bull's Eye (erythema migrans) rash, then laboratory testing will need to be obtained to aid in your diagnosis. Our preferred lab is Medical Diagnostic Labortory ( MDL) which participates with most insurance plans. As long as your insurance will allow it, MDL is where your lab testing will be sent. Certain insurance plans will not allow the use of MDL, in which case, your labs will be sent to the lab that your insurance mandates.


Laboratory testing that is obtained will also include studies for the other diseases (more commonly referred to as co-infections) that ticks carry. The list of other diseases includes Babesia, Bartonella, Ehrlichia (Anaplasma), and Mycoplasma. While ticks may carry Rocky Mountain Spotted Fever (RMSF), the symptoms are diagnostic and readily apparent. Testing for RMSF will be obtained if it is appropriate.