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The multiplicity of the clinical appearance of
Lyme disease makes it necessary to confirm the diagnosis by detecting the pathogen or specific antibodies. Isolation of the pathogen from infected tissue or body fluids is difficult, so that, to date, only serology is feasible for routine diagnosis. In view of a lack of standardisation of borrelia serology, the clinician must expect false negative, and–even more so–false-positive, results. Future laboratory diagnosis should be markedly improved by nucleic acid hybridisation for the detection of the pathogen, and the use of specific immunodominant antigens for antibody detection.