ELISA if positive obtain confirmatory Western blot
PCR
Cultures, serologies
LP with lymphocytic pleocytosis, elevated protein, normal glucose, + spirochete antibody, paired serum/CSF serologic tests,PCR
Must be performed in patients with neuro findings (facial nerve palsy, meningoencephalitis, etc)
CNS<unk>  will be treated with ceftriaxone
Arthrocentesis, serologic testing of fluid
Must be performed in patients with neuro findings (facial nerve palsy, meningoencephalitis, etc)
CNS<unk>  will be treated with ceftriaxone
Lyme disease
Enterovirus
Rabies
Hepatitis
Scarlet fever
Mononucleosis
Plague
Connective tissue disease