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Two-tier testing no better than a flip of a coin: Molecular Microbiological and Immune Characterization of a Cohort of Patients Diagnosed with Early Lyme Disease

ABSTRACT Lyme disease is a tick-borne infection caused by the bacteria Borrelia burgdorferi. Current diagnosis of early Lyme disease relies heavily on clinical criteria, including the presence of an erythema migrans rash. The sensitivity of current gold- standard diagnostic tests relies upon antibody formation, which is typically delayed and thus of limited utility in early…