Laboratory Services

Lyme Disease, Molecular Detection, PCR, Varies

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Updated Test Information:

Test Description
Lyme Disease, Molecular Detection, PCR, Varies
Synonym(s)

Borrelia burgdorferi by PCR; Lyme Disease (PCR); Lyme Disease, CSF; Tick-Borne Diseases; Spirochetes; Lyme Disease; Sensu lato group; Borrelia garinii; Borrelia afzelii; Borrelia mayonii Borrelia burgdorferi sensu lato genogroup

Test ID
PBORR
General Information

Useful for:



  • Supporting the diagnosis of Lyme disease in conjunction with serologic testing

  • Specific indications including testing skin biopsies when a rash lesion is not characteristic of erythema migrans, and testing synovial fluid or synovium to support the diagnosis of Lyme arthritis

  • See Acute Tick-Borne Disease Testing Algorithm

  • See also Meningitis/Encephalitis Panel Algorithm

  • This assay does not detect Borrelia miyamotoi. If infection with this organism is suspected, order BMIYB (Borrelia miyamotoi Detection PCR, Blood) or BMIYC (Borrelia miyamotoi Detection PCR, Spinal Fluid)

Specimen Type

  • CSF

  • Synovial fluid

  • Skin or synovial biopsy

Specimen Collection / Processing Instructions

  • CSF:

    • Container/Tube: Sterile vial 

    • Specimen Volume: 1 mL

    • Collection Instructions: Label specimen as spinal fluid



  • Synovial fluid:

    • Container/Tube: Sterile vial

    • Specimen Volume: 1 mL

    • Collection Instructions: Label specimen as synovial fluid



  • Tissue: (Skin or synovial biopsy)

    • Container/Tube: Sterile container with normal saline

    • Specimen Volume: Approximately 4 mm(3)

    • Collection Instructions:

      • Submit only fresh tissue

      • Skin biopsies:

      • Wash biopsy site with an antiseptic soap

      • Thoroughly rinse area with sterile water

      • Do not use alcohol or iodine preparations

      • A local anesthetic may be used

      • Biopsy specimens are best taken by punch biopsy to include full thickness of dermis

      • Label specimen with source of tissue





Required Information

Specimen source is required

Stability

  • Refrigerated (preferred): 7 days

  • Frozen: 7 days

Unacceptable Specimen Conditions

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Limitations

  • Serologic tests are recommended for diagnosis of Lyme disease. PCR may play an adjunctive role, but may not detect Borrelia burgdorferi DNA from cerebrospinal fluid (CSF) in cases of active or chronic disease. The presence of inhibitory substances may also cause a false-negative result. If clinical features of illness are highly indicative of Lyme neuroborreliosis, serologic testing on CSF is warranted. PCR test results should be used as an aid in diagnosis and not considered diagnostic by themselves. These results should be correlated with serologic and epidemiologic data and clinical presentation of the patient

  • Testing of CSF by PCR in patients with suspected Lyme neuroborreliosis should be requested only on patients with positive B burgdorferi antibody in serum confirmed by Western blot assay LYWB / Lyme Disease Antibody, Immunoblot, Serum and with abnormal CSF findings (elevated protein and WBC >10 cells/high-power field)

  • Concurrent infections with multiple tick-borne pathogens, including Ehrlichia muris eauclairensis, Anaplasma phagocytophilum, Babesia microti, and B miyamotoi (a relapsing fever Borrelia) have been reported in United States, and consideration should be given to testing for other pathogens if clinically indicated

  • This assay detects most members of the Borrelia burgdorferi sensu lato complex, including B andersonii, B americana, and B bissettii, which have been rarely detected in humans. Detection of DNA from these organisms would be reported as an atypical result and prompt additional laboratory testing to further identify the DNA present. The sensitivity of this assay for detecting these organisms has not been determined

  • This assay also detects some members of the B burgdorferi sensu lato (Bbsl) complex that are not considered to be human pathogens, but may be found in ticks and other animals. Therefore, this assay should not be used to test nonhuman specimens

  • This test should not be used to screen asymptomatic patients

Methodology

Real-Time Polymerase Chain Reaction (PCR)/DNA Probe Hybridization

Estimated TAT

1-4 days

Testing Schedule

Monday-Saturday

Test Includes

  • B. burgdorferi PCR

  • B. mayonii PCR

  • B. garinii/B. afzelii PCR

Retention

7 days

CPT Code(s)

87476; 87798 (x2)

Additional Information
Minimum Sample Volume

  • Spinal Fluid: 0.3mL

  • Synovial Fluid: 0.3 mL

  • Tissue: NA

Reference Range

Negative

Performing Lab

Mayo

LOINC Code(s)

31208-2; 94250-8; 94251-6; 94252-4; 59464-8