IS HISTORY USEFUL IN THE DIAGNOSIS OF LYME BORRELIOSIS

We performed a prospective study with 635 adults who presented to a Ly me disease diagnostic and treatment center to determine whether patien t history is helpful in the diagnosis of Lyme borreliosis. Standard as sessment self-report questionnaires were administered, and a detailed physical examination was performed. The patients had serologic testing and if ELISA was positive, a western blot was performed. Patients wer e categorized into four groups: definite Lyme borreliosis, probable, l ow probability, and Lyme borreliosis unlikely. Statistical analyses we re performed to determine if any of the self-reported symptoms had a h igh correlation with a definitive diagnosis of Lyme borreliosis. The m ajority of patients did not fulfill clinical and serologic criteria fo r Lyme borreliosis. The results of chi2 analyses comparing frequency o f reported symptoms in the definite and non-Lyme groups indicated that depression, Bell's palsy, and joint pain were the only symptoms that distinguished patients with Lyme borreliosis. Where the disease has a high public profile, reported symptoms of Lyme borreliosis correlated poorly with definite diagnosis.