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Difficulties in diagnosis of late stages of
Lyme disease include low sensitivity of serological testing and late inclusion of
Lyme disease in the differential diagnosis. Longer treatment modalities may have to be considered in order to improve clinical outcome of late
disease stages. These difficulties clinical cases of
Lyme borreliosis. The different clinical cases illustrate several aspects of late borreliosis: false negative serology due to narrow antigen composition of the used ELISA format, the need for prolonged antibiotic treatment in chronic or recurrent forms and typical presentations of late
Lyme disease, such as lymphocytic meningo-encephalitis and polyradiculoneuritis.