How is Lyme disease diagnosed?
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Your doctor may diagnose Lyme disease immediately based on your symptoms, particularly if you display the target-shaped red rash. However, additional tests may be done to determine your diagnosis. These include blood tests that look for the bacteria from ticks or antibodies fighting against those bacteria.
Your doctor may diagnose Lyme disease immediately based on your symptoms, particularly if you display the target-shaped red rash. However, additional tests may be done to determine your diagnosis. These include blood tests that look for the bacteria... More -
Johns Hopkins Medicine answered:Patient history is very important when diagnosing Lyme disease. The patient will be asked a series of questions like:
- Have you had a possible exposure to ticks?
- Do you live or work in an endemic area where it is common to contract Lyme disease?
- Have you recently experienced a tick bite?
- How has the rash progressed?
- Have you experienced any other symptoms? A detailed description of the rash may be helpful if it is not present at the time of the examination. The history that the rash expanded over several days, eventually surpassing 5 cm in diameter, is a useful clue.
Diagnosis of Lyme disease is aided by serologic testing, which should include antibody testing by ELISA, and if positive, the physician will follow up with Western blot testing for both immunoglobulin G (IgG) and M (IgM) antibodies. Six to eight weeks after infection, most patients will have an appropriate antibody response.
It is important to note that in patients with symptoms present for at least one month, a positive IgM test alone is insufficient evidence of infection and is more likely to be a false positive, rather than true positive, result.
Other diagnostic testing is available, including polymerase chain reaction (PCR) testing of blood, skin biopsy samples, cerebrospinal fluid, joint fluid, or urine testing. Some laboratories sell a Lyme urinary antigen test. At this time, these tests must all be considered to be research tools only. PCR testing of joint fluid may be a useful adjunct to diagnosis when performed in laboratories with careful control of possible exogenous contamination.
Patient history is very important when diagnosing Lyme disease. The patient will be asked a series of questions like: Have you had a possible exposure to ticks? Do you live or work in an endemic area where it is common to contract Lyme disease?... More -
History of exposure: A doctor will determine a history of exposure to potentially infected ticks, especially in areas of the country known to have Lyme disease.
Physical examination: Physical findings include the characteristic rash. The signs and symptoms of Lyme disease are nonspecific and are often found in other conditions, such as viral infections, various joint disorders (arthritis), muscle pain (fibromyalgia), chronic fatigue syndrome, and even depression.
Enzyme-linked immunosorbent assay (ELISA) test: The enzyme-linked immunosorbent assay (ELISA) test is used most often to detect Lyme disease. ELISA detects antibodies to B. burgdorferi. Antibodies are proteins made by the body to fight off antigens (foreign invaders) such as B. burgdorferi. ELISA is not used as the sole basis for diagnosis because it can sometimes provide false-positive results.
Western blot test: If the ELISA test is positive, another assay called the Western blot is usually done to confirm the diagnosis. The Western blot detects antibodies to several proteins of B. burgdorferi.
Polymerase chain reaction (PCR): The polymerase chain reaction (PCR) test helps detect bacterial DNA in fluid drawn from an infected joint. PCR is not effective at detecting infection of blood or urine, and is used for individuals who may have chronic Lyme arthritis. PCR may also be used to detect persistent infection in the cerebrospinal fluid of individuals who have nervous system symptoms.
Magnetic resonance imaging (MRI): Magnetic resonance imaging (MRI) may be used in early or late stage Lyme disease to determine neurological (nerve) damage.
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History of exposure: A doctor will determine a history of exposure to potentially infected ticks, especially in areas of the country known to have Lyme disease. Physical examination: Physical findings include the characteristic rash. The signs... More -
Healthwise answered:Lyme disease is often hard to diagnose. Your doctor will take a careful medical history and do a physical examination to help diagnose early Lyme disease. You may be asked if you have recently visited an area where you may have been exposed to ticks. The doctor will ask about your symptoms and look for physical signs of Lyme disease. The clearest physical sign is an expanding, circular red rash (called erythema migrans ).
Lyme disease tests are blood tests that help confirm a diagnosis of Lyme disease. These tests can detect antibodies to the bacteria that cause Lyme disease, but they may not be needed. The decision about when to use blood tests for Lyme disease depends on whether your doctor strongly thinks you have Lyme disease and whether the test results will change the course of your treatment.
Other tests, such as a skin biopsy, may be done to confirm a diagnosis.
If possible, put the tick that was attached to you in a dry jar or a ziplock bag and take it to the doctor with you. Sometimes tests can be done on the tick to see if it is a carrier of Lyme disease.
Lyme disease is often hard to diagnose. Your doctor will take a careful medical history and do a physical examination to help diagnose early Lyme disease. You may be asked if you have recently visited an area where you may have been exposed to... More
