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Lyme Disease Test
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Lyme Disease Test
, Lyme Culture, Lyme PCR
See Also
Lyme Disease
Lyme Titer
Labs
Two tiered protocol
See Lyme Test
Tier 1:
Lyme Titer
(
ELISA
)
Not needed if
Erythema Migrans
in endemic areas
False Positive Rate
is high
Positives are reflexed to
Western Blot
Tier 2:
Lyme Western Blot
Confirms
Lyme Titer
result
Labs
Other
Synovial Fluid
Lyme PCR
Joint Aspiration
in cases of suspected Lyme
Arthritis
Cerebrospinal fluid (CSF) for Intrathecal Lyme
Antibody
production
Indicated for neurologic symptoms
Skin Biopsy of
Erythema Migrans
for Quantitative PCR
Most sensitive test in early
Erythema Migrans
May be indicated in atypical rash presentations
Sensitivity: 81%
Nowakowski (2001) Clin Infect Dis 33:2023-7 [PubMed]
Skin Culture of
Erythema Migrans
(uncommonly performed)
Sensitivity: 60-80% for organisms
Sample types
Saline-lavage needle aspirate
Punch Biopsy
(2 mm) of leading edge
C6 Peptide assay (IgG
Enzyme Linked Immunosorbent Assay
)
Under study as of 2012 for replacement of the two tiered protocol
Labs
Precautions
Lyme urine
Antigen
High
False Positive Rate
and not recommended
Borrelia Burgdorferi
IgG and IgM
Persists for years following effective antibiotic treatment
Positive test after treatment does not indicate failed antibiotics or chronic infection
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