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Lyme Disease Test

Test Overview

A Lyme disease blood test detects antibodies to the Lyme disease bacteria Borrelia burgdorferi. It is spread by certain kinds of ticks. Lyme disease may be difficult to diagnose because its symptoms are similar to those of many other illnesses. If Lyme disease is suspected, a careful medical history and physical examination will be done. Antibody tests can sometimes be used to help confirm a diagnosis of Lyme disease. Other tests may be done in certain situations.

Antibody tests
Antibody tests are the most commonly used tests to help confirm a diagnosis of Lyme disease and monitor its treatment. Antibody testing may also be done on fluid from the spine or from a joint.

It may take up to 2 months after becoming infected before antibodies can be detected in a blood test. Once formed, antibodies usually persist for many years, even after successful treatment of the disease. Finding antibodies to the Lyme disease bacteria does not indicate whether you were infected recently or sometime in the past.

There are three types of antibody tests to detect Lyme disease.

Enzyme-linked immunosorbent assay (ELISA). This common and rapid test to detect Lyme disease antibodies is considered the most sensitive screening test for Lyme disease.
Indirect fluorescent antibody (IFA). This test also screens for Lyme disease antibodies, but it may produce false results more often than ELISA.
Western blot test. This test also detects Lyme disease antibodies and can confirm the results of an ELISA or IFA test. It is most often done to detect a chronic Lyme disease infection.
Antibody testing should be done in a two-step process, using either the ELISA or IFA followed by the Western blot test. ELISA is considered a more reliable and accurate test than IFA, but IFA may be used if ELISA is not available. The Western blot test (which is a more specific test) should be done in all people who have tested positive or borderline positive (equivocal) in an ELISA or IFA test.

Other tests
Polymerase chain reaction (PCR) test. Polymerase chain reaction (PCR) testing detects the genetic material (DNA) of the Lyme disease bacteria. PCR testing may be useful for identifying a current (active) infection if you have Arthritis that does not improve with Antibiotic treatment. PCR testing is not done as frequently as antibody testing because it requires technical skill and expensive equipment. Also, standards have not yet been developed for PCR testing and there is a risk of false-positive test results.
Skin culture. A skin culture evaluates a tissue sample for the bacteria that causes Lyme disease. It may take several weeks for test results to come back. For this reason, antibody testing is done more frequently than a tissue culture.
Why It Is Done

A test for Lyme disease is done to help confirm a diagnosis of Lyme disease. Initial symptoms of Lyme disease include an expanding red skin rash at the site of the tick bite. The rash may look like a bull's-eye, with a pale center area surrounded by a bright red rim. The rash usually fades in 3 to 4 weeks, but it may return. Initial symptoms may also include fatigue, headache, stiff neck, fever, chills, and muscle and joint pain. Symptoms of chronic Lyme disease infection include joint pain, stiffness, and problems with the heart, brain, or nerves. Testing is most accurate when you have risk factors for Lyme disease or symptoms of the disease.

http://www.webmd.com/hw/arthritis/hw5113.asp
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