Re: IDSA Guidelines...can anyone tell me what this means?


Rita Stanley wrote:
"the 3rd Man" <derdrittemann2003@xxxxxxxxx> wrote in message
news:1160702036.180233.126370@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

Why would you be talking about serologic testing in relation to an EM
rash...when you have just acknowledged that a clinical observation of
an EM is sufficient to diagnose?

Because there are docs who want to confirm the EM rash with testing; they
want the security of some lab results. The GL's are telling them not to do
that.

Ahhh...yes, that makes sense. Not cost -efficient, either. Not a good
use of healthcare resources.

I've got feedback from lots of folks whose docs did testing along with EM
rash presentations. Not uncommon at all. The docs don't care to understand
the tests. Modern docs are dependent on tests. Others feel that the rash is
'something else' like ringworm or a
spider bite' and want to test to show the patient that their concerns about
LD are unnecessary. I've heard tons of these stories. Tons.


Doesn't make sense...

Makes sense to me.

Think like a doc presented with a recipe to follow.




Confirmation of the diagnosis by testing is required before treatment for
anything other than EM diagnosis.

What's your source for this, please?

No source. That's how I read it. Maybe I read it wrong, but who else is
reading it the way I do?

Thanks, that helps. Not saying you're wrong...actually suspect that you
are right...

Everyone, reads it that way, I would think, maybe except me...(and I
vaguely recall a similar discussion that I had here with Greg Gerber
and Weisman and I think they both wanted to reach through their screens
and strangle me). LOL.

I am just having a hard time believing they are really that mechanical
in their approach to what is by everyone's estimation, a very
complicated diagnosis.

And it's my experience that with any situation, the physician is going
to evaluate laboratory tests as just one component...(at least
hopefully so).

In other words, these people are extremely bright...I just can't
believe they can be that damned stupid on this...while at the same time
acknowledging the weaknesses inherent in the available tests.


And...if the "clinical" aspect is over-ruled...countered by a blood
test...isn't that really pure serodiagnosis?

Yes. Call it a 'confirmation' though. Goes on all the time for lots of
diseases. No thinking required. If you can read a recipe (granted, this one
is confusing), you can diagnose and treat disease.

I guess that's what I really want to know...if a doc reaches the
diagnosis...but the blot doesn't confirm...do these guidelines suggest
that he NOT treat?

I'm not entirely sure that they do, in fact.

.