Diagnosis

Antibodies attack the parasite when entering the body limiting the number of detectable parasites within the blood and limiting the detection and diagnosis via blood

Diagnoses may include:

• Tissue or fluid for culture may be used for diagnosis (not common).

• Polymerase chain reaction assays (PCR) are not often used with blood or cerebrospinal as the concentration of bacteria is low. Joint fluid may be used however contamination makes it uncommon for diagnosis.

• Confirmation of the disease is often from antibodies to the parasite in the serum using a two-tier procedure. There should not be a diagnosis of Lyme disease unless both tests are considered.

  1. 1. 1. 1. 1. 1. 1. 1. An ELISA test is first performed providing an approximate concentration of antibodies. Step two is then done if this test is positive or equivocal

                       2. A western immunoblot indicates the antibodies against protein antigens of B.burgdorferi are present. “The presence of antibodies against at least either 2 (for IgM) or 5 (for IgG) proteins of B burgdorferi are required for the immunoblot result to be considered positive (Shapiro,2014)."

• ELISA for antibodies against C6VlsE as a single test for Lyme disease have may be used but it is less specific than the two-tier test.

• Antibody tests are not often used for early Lyme disease or for people that have received antimicrobial treatment as antibodies may have not formed yet.

• Misdiagnosis often occurs due to false positives as well as the signs appearing due to other reasons. If the patient had antibodies to B burgdorferi they may test positive for many years as well indicating a false positive.