This is especially so if the patient has no rash and does not recall an episode of tick bite.
If a patient remembers a tick bite and then becomes unwell, Lyme disease is a possibility.
There is no diagnostic test that is absolutely reliable in confirming a case of Lyme disease.
Negative test results therefore, do not necessarily mean it is absent.
After all exclusionary tests have been done; the diagnosis can be made on clinical grounds alone.