Lyme specialist Virginia Savely, DNP, writes about the complexities of diagnosing Lyme disease in the latest issue of Nurse Practitioner journal

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In the July 2010 The Nurse Practitioner

44 The Nurse Practitioner • Vol. 35, No. 7

A diagnostic dilemma
By Virginia Savely, DNP, MEd, MSN, RN, FNP-C

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 by tenfold.1 LD is caused by the bacterium Borrelia burgdorferi (B. burgdorferi), a genetically sophisticated spirochete with stealth pathology and numerous methods of immune system evasion. Like its close spirochetal cousin Treponema pallidum (the bacterium that causes syphilis), B. burgdorferi can cause disabling neurologic 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 disability ensue for thousands of patients.2 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. ■