Does Lyme disease show up in spinal fluid?
The most common testing for Lyme disease is conducted on the blood. However, when central nervous system Lyme disease is suspected, the spinal fluid should be tested as well. When Lyme arthritis is suspected and the fluid in the joint is aspirated, the joint fluid may be tested for evidence of Lyme disease.
What is the most common confirmatory test for Lyme disease?
- Enzyme-linked immunosorbent assay (ELISA) test. The test used most often to detect Lyme disease, ELISA detects antibodies to B. burgdorferi.
- Western blot test. If the ELISA test is positive, this test is usually done to confirm the diagnosis.
Can a lumbar puncture diagnose Lyme disease?
A lumbar puncture should be performed if Lyme meningitis is in the differential diagnosis. Whether all patients with cranioneuropathy require lumbar puncture before treatment is controversial. Occasionally Lyme disease presents as pseudotumor cerebri, and in such cases an opening pressure is essential for diagnosis.
What CSF finding is most sensitive for Lyme meningitis?
In patients with Lyme meningitis, the CSF is characterized by low-grade lymphocytic pleocytosis, low glucose levels, and elevated protein levels. Oligoclonal bands reactive to B burgdorferi antigens may be present. Demonstration of the specific antibody to B burgdorferi aids in the diagnosis.
What does a positive IgG Lyme test mean?
Most of the time, the IgG western blot must be positive in order to indicate a potential infection with Lyme disease. The IgM antibodies are the first antibodies to be produced in the body in response to an infection.
Is WBC elevated with Lyme disease?
In patients with Lyme disease, the white blood cell count (WBC) can be normal or elevated. The erythrocyte sedimentation rate (ESR) is usually elevated.
How accurate is a spinal tap for Lyme?
Anti-Borrelia antibody CSF-to-serum index has been reported to show a 97% specificity and 75% sensitivity for the diagnosis of neuroborreliosis. A CSF-to-serum index greater than 1.0 suggests synthesis of antibody in the central nervous system (CNS).