Holly M. Frost, MD
Department of Pediatrics
Denver Health Medical Center
University of Colorado School of Medicine
The pitfalls of serologic assays for the diagnosis of tick-borne diseases: a case series and review of the literature
Dr. Frost is an Assistant Professor in the Department of Pediatrics at the University of Colorado School of Medicine and Denver Health Medical Center. She obtained her medical degree from the Medical College of Wisconsin and completed her pediatric residency at the University of Colorado. Dr. Frost served as a Physician Scientist for Marshfield Clinic for 5 years prior to rejoining the faculty at the University of Colorado. Her research focuses on the development and implementation of novel diagnostic tests and the use of these tests to better describe clinical disease. Her prior work has focused on the study of emergency tick-borne pathogens and has included the validation of a serological assay for Powassan virus, public health serosurveillence for Powassan virus, clinical validation of a rapid point-of-care diagnostic assay for Lyme disease, and clinical descriptive studies of anaplasmosis and babesiosis. In addition to her tick-borne pathogen research Dr. Frost serves on the antimicrobial subcommittee at Denver Health Medical Center and was formerly the chair of pediatric antibiotic stewardship for the Marshfield Clinic system. She directs research studies on the design and implementation of diagnostic tests for acute otitis media, conjunctivitis, and pharyngitis in children.
Conference Lecture Summary
Lyme disease often presents with non-specific clinical findings that can be confused with other diseases and create diagnostic dilemmas for providers. Despite tremendous research devoted to the development of improved Lyme diagnostic tests, two-tiered Lyme serology remains the mainstay of testing. Unfortunately, significant cross-reactivity exists between Lyme immunoassays and those for other diseases with non-specific clinical findings, including infectious mononucleosis. In this talk we explore the pitfalls of two-tiered Lyme serology to verify or exclude the diagnosis of Lyme disease by examining a case series of patients with clinical presentations and diagnostic tests suggestive of both Lyme disease and infectious mononucleosis.