Lyme disease needs to be diagnosed clinically, using your medical history in conjunction with one or more of the available tests. There are a number of tests for these illnesses, However, they are not sufficiently sensitive to be conclusively diagnostic. Your test may come back negative by CDC standards, yet you may still be positive for Lyme disease.
Two schools of thought, exemplified by the organizations International Lyme & Associated Diseases (ILADS) and the Infectious Disease Society of America (IDSA) have developed with regards to the diagnosis and treatment of Lyme disease. The root of the controversy, put simply, is the lack of the reliable biological markers and diagnostic tests for the disease. In addition, it is also difficult to determine whether a patient has been fully cleared of the disease. Therefore, arguments over diagnosis and treatment approaches will continue.
Lyme disease is a clinical diagnosis, based on a patient’s symptoms, history, and examination. A patient can test negative and still have Lyme disease. Many physicians have not received education on chronic Lyme disease in medical school, since Lyme is still being researched.