Removal · field guidance

False-negative early Lyme

In the first 4 weeks after a bite, two-tier serology misses 40-60% of Lyme cases because antibodies have not yet developed.

Steps

schema.org/HowTo

01
Antibody-based tests cannot detect infection that is too recent to mount a response.
02
In the first 1-2 weeks, sensitivity is often under 40%.
03
Patients with characteristic EM rash should be treated clinically without waiting for serology.
04
Negative early tests should be repeated at 4-6 weeks if symptoms continue.
05
Early antibiotics may further blunt seroconversion and lead to persistent seronegativity.

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