Laboratory Diagnosis of Tick-Borne Infections

Lyme Disease - Diagnostic Approach

July 2010

When evaluating a patient with suspected Lyme disease, the diagnosis is often clinical, and is based on symptoms and objective clinical findings. The most characteristic manifestation is that of erythema migrans, also known as a target lesion or bull’s eye rash. Erythema migrans is believed to occur in 60-75% of patients with Lyme disease. Other clinical findings may include facial palsy or arthritis.

There are several situations where laboratory testing is not recommended. The first situation is when a patient presents with an appropriate exposure history and a “classic” erythema migrans rash. In this situation, it is typically recommended to bypass laboratory testing and treat the patient according to approved guidelines. The second scenario where lab testing should not be performed is when a patient lacks symptoms, an appropriate exposure history, or is from a nonendemic region and has not recently visited an endemic area.

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Lyme Disease - Diagnostic Approach

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Jump to section:

• Introduction
• Outline
• Patient Case 1
• Laboratory Workup
• Conventional Methods for Diagnosis of Ehrlichiosis and Anaplasmosis
• Conventional Methods for Diagnosis of Ehrlichiosis and Anaplasmosis
• Conventional Methods for Diagnosis of Ehrlichiosis and Anaplasmosis
• Typical Positive Result by IFA
• Conventional Methods for Diagnosis of Ehrlichiosis and Anaplasmosis
• Diagnostic Tests for HME and HGA
• Conventional Methods for Diagnosis of Ehrlichiosis and Anaplasmosis
• Conventional Methods for Diagnosis of Ehrlichiosis and Anaplasmosis
• Patient Case 2
• Giemsa-stained Preparation Slide
• Giemsa-stained Preparation Slide
• Conventional Methods for Diagnosis of Babesia
• Conventional Methods for Diagnosis of Babesia
• Conventional Methods for Diagnosis of Babesia
• Conventional Methods for Diagnosis of Babesia
• Conventional Methods for Diagnosis of Babesia
• Patient Case 3
• Lyme Disease - Diagnostic Approach
• Conventional Methods for Diagnosis of Lyme Disease
• Patient Case 3 (continued)
• Diagnosis of Lyme Disease
• Lyme Disease - Serologic Assays
• Lyme Disease - Serologic Assays
• Lyme Disease - Serologic Assays
• Patient Case 3 (continued)
• Lyme Disease - Serologic Assays
• Patient Case 3 (continued)
• Lyme Disease - Factors to Consider
• Conclusions
• References
• Questions?