Laboratory Diagnosis of Tick-Borne Infections
Part 2
Lyme Disease: Diagnostic Approach
July 2010
Now as mentioned by Dr. Binnicker in part 1 of this hot topic, the diagnosis of Lyme disease is often clinical, and is based on symptoms and objective clinical findings such as the classic “bulls-eye rash” which is otherwise known as erythema migrans and other suspicious symptoms such as facial palsy and arthritis. Laboratory testing is generally not recommended when patients present with erythema migrans or they lack symptoms, exposure history, or they’re from a nonendemic area. But in this case, the patient does have symptoms, even though are not classic and the family does live in an endemic area.
Lyme Disease: Diagnostic Approach |
Jump to section:
- Introduction
- Presentation Outline
- Tick-Borne Diseases
- Advantages and Limitations of Conventional Tests
- Molecular Diagnostic Methods Potential Advantages
- Molecular Diagnostic Methods Potential Disadvantages
- Treatment and Diagnostic Recommendations
- Case 1
- Diagnostic Workup
- Representative Image Giemsa-stained Peripheral Blood Smear
- Differential Diagnosis
- Which one is Plasmodium falciparum?
- Main Morphologic Features Table
- Classic Maltese Cross
- Extracellular Forms of Babesiosis
- Side-by-Side Comparison
- Further Workup
- Malaria PCR
- Babesia microti PCR
- Advantages/Uses of PCR
- Potential Disadvantages
- Potential Disadvantages
- Case 2
- Lyme Disease: Diagnostic Approach
- Reported Cases of Lyme Disease, 2008
- Serologic Assay: Test of Choice for Diagnosis of Lyme Disease
- Case 2, Further Workup
- Potential Roles for PCR
- Which Specimens Should be Tested by PCR?
- PCR for Detection of Borrelia burgdorferi DNA in Blood
- Case 3
- Live Tick Image
- Tick Image Close Up
- IDSA Guidelines
- IDSA Guidelines, continued
- Testing of Ticks by PCR
- Case 4
- Tick-Borne PCR Panel
- Diagnostic Tests for HME and HGA
- PCR for Diagnosis of Ehrlichiosis/Anaplasmosis
- Ehrlichia and Anaplasma PCR Assay Graph
- Phylogenetic Tree
- Ehrlichia muris-like Organism
- All Patients with EML had Tick Exposure
- Prevention of Tick-Borne Diseases
- Conclusions
- Conclusions, continued
- Questions?
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