Lyme borreliosis is caused by a growing list of related, yet distinct, spirochetes with complex biology and sophisticated immune evasion mechanisms. It may result in a range of clinical manifestations involving different organ systems, and can lead to persistent sequelae in a subset of cases. The pathogenesis of Lyme borreliosis is incompletely understood, and laboratory diagnosis, the focus of this review, requires considerable understanding to interpret the results correctly. Direct detection of the infectious agent is usually not possible or practical, necessitating a continued reliance on serologic testing. Still, some important advances have been made in the area of diagnostics, and there are many promising ideas for future assay development. This review summarizes the state of the art in laboratory diagnostics for Lyme borreliosis, provides guidance in test selection and interpretation, and highlights future directions.

中文翻译：

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莱姆疏螺旋体病的实验室诊断

莱姆疏螺旋体病是由越来越多的相关但不同的螺旋体引起的，这些螺旋体具有复杂的生物学和复杂的免疫逃避机制。它可能导致涉及不同器官系统的一系列临床表现，并可能导致部分病例出现持续性后遗症。莱姆疏螺旋体病的发病机制尚不完全清楚，实验室诊断是本综述的重点，需要充分了解才能正确解释结果。直接检测传染原通常是不可能的或不切实际的，因此需要继续依赖血清学检测。尽管如此，在诊断领域已经取得了一些重要进展，并且对于未来的分析发展有许多有希望的想法。这篇综述总结了莱姆疏螺旋体病实验室诊断的最新技术，