Borrelia burgdorferi DNA, Qualitative Real-Time PCR, Miscellaneous

The following is a list of what is included in the item above. Click the test(s) below to view what biomarkers are measured along with an explanation of what the biomarker is measuring.

BORRELIA BURGDORFERI DNA,

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The Borrelia burgdorferi DNA, Qualitative Real-Time PCR, Miscellaneous test contains 1 test with 2 biomarkers.

Borrelia burgdorferi DNA, Qualitative Real-Time PCR, Miscellaneous

Lyme disease, caused by the spirochete Borrelia burgdorferi, is the most common tick-borne illness in North America and Europe. Its presentation can range from localized skin rash to systemic manifestations affecting the skin, joints, nervous system, and heart.

Diagnostic Considerations:

  1. Clinical Examination: A classic feature of Lyme disease is erythema migrans, a skin rash that occurs within 3-30 days of the tick bite, often described as a "bull's-eye" appearance. However, not everyone with Lyme disease gets this rash. Other clinical symptoms might include fever, fatigue, headache, muscle and joint aches, and swollen lymph nodes.

  2. Epidemiological Evidence: History of tick exposure, especially in areas known to be endemic for Lyme disease, adds significant weight to the diagnosis.

  3. Direct Detection: The qualitative real-time PCR for Borrelia burgdorferi DNA offers direct evidence of the bacterium's presence in blood, fluids, or tissues. A positive result confirms the presence of Borrelia DNA, supporting a diagnosis of Lyme disease.

Implications of Test Results:

  • Positive PCR Result: Indicates the presence of Borrelia burgdorferi DNA in the tested sample. It is crucial evidence supporting the diagnosis, especially in early disease stages or in cases where serology might not yet be positive.

  • Negative PCR Result: While a negative result means no Borrelia DNA was detected, it does not rule out Lyme disease. Factors that can affect this include:

    • Timing of sample collection: Borrelia DNA might be more detectable in early stages.
    • Previous antibiotic treatment: Can reduce the amount of Borrelia in the body.
    • Sample type: Certain samples might have a higher likelihood of detecting the bacterium.

  • Serology: Given the limitations of PCR, serological testing remains a mainstay for Lyme disease diagnosis, especially in later stages. Two-tiered testing, including an enzyme immunoassay (EIA) followed by Western blots, is commonly recommended.

Conclusion:

The diagnosis of Lyme disease requires a multifaceted approach, combining clinical examination, epidemiological evidence, and laboratory testing. While the real-time PCR test for Borrelia burgdorferi DNA provides valuable direct evidence of the bacterium's presence, clinicians should interpret the results in the context of the patient's clinical picture and history. In cases of a negative PCR result but strong clinical suspicion, serological testing can offer additional diagnostic insight.

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