B. burgdorferi (Lyme)
Label Mnemonic: CLYMEAB
Epic Lab Code: LAB2654
Downtime Form: A-1a Miscellaneous Request
Commercial Mail-out Laboratory
5231 RCP
356-8593
Specimen(s):
CSF
Collection Medium:
CSF collection kit
Minimum:
Preferred Minimum: 3 mL CSF
Absolute Minimum: 0.5 mL CSF
Rejection Criteria:
Contaminated or heat-inactivated specimens.
Turn Around Time:
1-3 days upon receipt at reference laboratory
Reference Range:
0.99 LIV: Negative - Antibody to B. 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
                     B. burgdorferi detected.
Interpretive Data:
The detection of antibodies to B. burgdorferi in cerebrospinal fluid 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 immunoblot. Both IgM and IgG immunoblots should be performed on samples less than 4 weeks after appearance of erythema migrans. Only IgG immunoblot should be performed on samples greater than 4 weeks after the disease onset. IgM immunoblot 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 immunoblot testing within 10 days.
Comments:
Note - Once this test is performed, if: a) Negative - no further testing is done. b) Positive or equivocal - Immunoblot testing will be performed on the original sample upon receiving a request. Sample will be held for 30 days only.
Methodology:
Semi-Quantitative Enzyme-Linked Immunosorbent Assay
CPT Code:
86618