When should you order a Lyme titer?

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Lyme titers should be ordered for patients with signs or symptoms of disseminated Lyme disease, but who do not have the pathognomonic erythema migrans rash (strength of recommendation [SOR]: C, based on expert opinion). Symptomatic patients with erythema migrans should be treated without being tested, given the high probability of having Lyme disease.

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