From the CDC, New England Journal of Medicine and Columbia University (Brian Fallon) --
Deer ticks, Ixodes scapularis carry another Lyme like bacteria. It appears to be a nasty spirochete in the Lyme family. No test is currently available: Borrelia miyamoto. We have known about this germ since 2001. It caught the attention of health authorities: a study published in the New England Journal of Medicine reported 21% of 14 patients evaluated in a Lyme clinic in Southern New York, with only flu-like symptoms, tested positive. (We do not have the test yet). Some patients sero-converted. The opposite of STARI, which gives a bulls eye rash, this spirochete does not cause EM (Lyme rash) but presents with flu-like symptoms.
It may cause cases of a sero-negative illness which may resemble chronic Lyme disease according to Dr. Brian Fallon as reported on CBC July 2, 2013.
A test is only available to researchers and the CDC.
Yes, as many have said all along, the diagnosis of Lyme disease is based primarily on clinical grounds, not laboratory data. What else don't we know?