Adult Preferred Minimum: 3 mL CSF Adult/Pediatric Absolute Minimum: 0.5 mL CSF

0.99 LIV: Negative - Antibody to Borrelia burgdorferi not detected. 1.00-1.20 LIV: Equivocal - Repeat testing in 10-14 days may be helpful. 1.21 LIV or greater: Positive - Probable presence of antibody to Borrelia burgdorferi detected.

*** Serum testing for Lyme Antibody (Borrelia burgdorferi) should be sent to Clinical Microbiology, 6004 BT. Note - Once this test is performed, if: a) Negative - no further testing is done. b) Positive or equivocal - Western blot testing will be performed on the original sample upon receiving a request. Sample will be held for 30 days only.

LIV = Lyme Index Value The detection of antibodies to Borrelia burgdorferi in CSF may indicate central nervous system infection. However, consideration must be given to possible contamination by blood or transfer of serum antibodies across the blood-brain barrier. Current CDC recommendations for the serologic diagnosis of Lyme disease are to screen with a polyvalent ELISA test and confirm equivocal and positive results with Western blot. Both IgM and IgG Western blots should be performed on samples less than eight weeks after appearance of erythema migrans. Only IgG Western blot should be performed on samples greater than eight weeks after the disease onset. IgM Western blot in the chronic stage is not recommended and does not aid in the diagnosis of neuroborreliosis or chronic Lyme disease. Please submit requests for appropriate Western blot testing within 10 days.