Laboratory Diagnosis of Tick-Borne Infections
Part 2
Which Specimens Should be Tested by PCR?
July 2010
The question is, which specimens should be tested and which ones provide the greatest diagnostic yield? To examine this question, we retrospectively examined the positivity rates of over 23,000 specimens tested by real-time PCR for Borrelia burgdorferi DNA. And it turned out, synovial fluid and tissue samples gave the highest yields, with positivity rates of 6.4% and 6.5% respectively, and surprisingly, CSF and blood only had positivity rates of 0.1% or less. Even more concerning is that 8 of the patients with a positive synovial fluid PCR result also had a blood specimen that was tested concurrently, and all 8 of these specimens were negative. So if only blood had been tested, these cases would have been missed.
Which Specimens Should be
Tested by PCR? |
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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