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Related Experiment Videos

Laboratory testing for suspected Lyme disease.

Jonas Bunikis1, Alan G Barbour

  • 1Departments of Medicine and Microbiology and Molecular Genetics, University of California-Irvine, Irvine, California, USA. jbunikis@uci.edu

The Medical Clinics of North America
|May 2, 2002
PubMed
Summary

Diagnosing Lyme disease relies on antibody detection, as cultivation and PCR methods have limitations. Current serologic testing, while practical, requires careful interpretation due to potential false positives and challenges with new Borrelia species.

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Area of Science:

  • Medical Diagnostics
  • Infectious Diseases
  • Microbiology

Background:

  • Laboratory testing for Borrelia burgdorferi infection aids physicians in diagnosing Lyme disease.
  • Cultivation and PCR methods for B. burgdorferi are limited by cost, sensitivity, and standardization issues.
  • Antibody detection is the most common diagnostic approach, but lacks perfect sensitivity and specificity.

Purpose of the Study:

  • To review the methods for laboratory diagnosis of Lyme disease.
  • To discuss the limitations and practical considerations of current diagnostic approaches.
  • To highlight emerging challenges in Lyme disease testing.

Main Methods:

  • Review of existing laboratory diagnostic techniques for B. burgdorferi.
  • Discussion of serologic assays, including ELISA and Western blot.

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  • Analysis of limitations such as false positivity and differentiation between past and current infections.

    • Main Results:

    • Antibody detection is the most practical method but requires careful interpretation.
    • The two-test approach (ELISA followed by Western blot) remains a reliable assessment.
    • New challenges include vaccine-induced seropositivity and novel Borrelia species.

    Conclusions:

    • Serologic testing for Lyme disease is recommended only when clinical suspicion is high.
    • Physician's assessment of pretest likelihood is crucial for accurate diagnosis.
    • Ongoing research is needed to address limitations and emerging challenges in Lyme disease diagnostics.