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Is Lyme disease being overlooked during infectious disease consultations?

Infectious disease doctors at one center in France looked at 355 patients who were referred for consultation for presumed Lyme disease. Only 48 of those patients were diagnosed with Lyme disease using the European Union Concerted Action on Lyme Borreliosis (EUCALB) criteria. Could Lyme disease have been dismissed in any of the remaining 86% (n=307) of individuals?