I think depending on the patients history, some doctors do an "antibiotic challenge test" to help draw the Lyme bacteria out from where it might have taken up residence.

I've always heard people say that Lyme hides and tries to evade the immune system. I never thought this was true until I started looking at what some of the Lyme researchers have been publishing. Dr. Eva Sapi out of the University of New Haven has a paper that shows that the Lyme bacterium changes shape and does hide in biofilms. The University of Yale Medical school showed that Lyme proteins remained in mice who had Lyme and were treated with antibiotics. There are lots of small studies out there showing stuff like this, which makes this so complicated to understand...lots of grey area, for sure.

Unfortunately, Lyme research is small and it is not well funded. And the research is not conducted in humans because no IRB would ever approve that study. It's really why we don't know as much about it as we should.