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QuantiFERON ELISA with Borrelia burgdorferi peptide antigens was previously shown to reliably detect IFN-γ in blood samples from adult patients with early Lyme disease and the response disappeared rapidly after treatment. We evaluated the response before and after appropriate antibiotic therapy in adolescent and adult subjects with more diverse stages of the illness. Blood was obtained from clinician-identified Lyme disease patients with constitutional complaints, erythema migrans, nerve palsy, cardiac abnormality, or arthritis before (n =