The symptoms of Lyme disease can sometimes be mistaken for other diseases and conditions.
The cognitive and neurological symptoms of Lyme disease can be similar to other conditions such as multiple sclerosis.
Infectious mononucleosis and influenza are viral infections with similar symptoms of fatigue, fever and muscle aches also associated with Lyme disease.
The arthritic symptom of Lyme disease is similar to the joint pain associated with other forms of arthritis, particularly rheumatoid arthritis.
When diagnosing Lyme disease the following factors should be taken into account:
Laboratory tests alone should be not used to confirm diagnosis. A patients medical history and their signs and symptoms should be considered alongside their test results. Physicians should be aware of false positive results (in which patients tests positive but are not infected with Lyme disease bacteria) and false negative results (in which the patient tests negative for Lyme disease but are infected).
Due to the issues surrounding diagnosis, a two stage testing process is recommended which measures the body's production of antibodies to Borrelia burgdorferi (the Lyme disease bacterium). Firstly, this involves taking an ELISA or IFA. An ELISA (Enzyme-Linked ImmunoSorbent Assay) is a biochemical technique used to detect the presence of an antibody or an antigen in a sample. Similar to an ELISA an IFA (indirect immunofluorescence assay) is a technique used to detect antibodies in a sample. However with an IFA, antibodies are labeled with a compound which makes them glow green under ultraviolet light.
In order for ELISA and IFA tests to be of use, they can only be used around 2-4 weeks after the bite of an infected tick. After this time the body has produced sufficient levels of antibodies to the Lyme disease. If the tests are taken earlier false negative results may arise in patients who display erythema migrans (see bull's eye wound of Lyme disease). Therefore these tests are more appropriate for patients showing late signs and symptoms of Lyme disease.
Lyme disease is caused by spirochetes – spiral shaped bacterium (in this case Borrelia burgdorferi) which can cause diseases which are renowned for being hard to detect and are imitators of other diseases.
The Lyme spirochete can remain in a non-metabolic state for years in the body before becoming active.
Whilst in this non-metabolic state they are resistant to antibiotics.
The Lyme spirochete attaches tip first to the human cells. Once inside the cell, it causes the cell to release digestive enzymes.
These digestive enzymes dissolve the cell and allow the Lyme spirochete to travel around the body. This combination of digestive enzymes and Lyme spirochetes allows efficient transport of the Borrelia burgdorferi around the body.