Clinics and Departments

Laboratory Services

Lab Dept:

Microbiolgy/Virology

Test Name:

LYME DISEASE PCR, SPINAL/SYNOVIAL FLUID OR FRESH TISSUE

General Information

Lab Order Codes:

LYPCR

Synonyms:

Borrelia burgdorferi PCR; Lyme Disease PCR; Lyme Disease by Polymerase Chain Reaction

CPT Codes:

87476 – Borrelia burgdorferi, amplified probe technique

Test Includes:

A positive or negative result indicating the presence or absence of Borrelia burgdorferi DNA in the specimen submitted.

Logistics

Test Indications:

Confirmation of active Lyme Disease. Monitoring Lyme Disease treatment. Diagnosing and monitoring Lyme arthritis.

PCR testing should be limited to patients with at least an equivocal or positive serologic test for antibody to Borrelia burgdorferi.

Lab Testing Sections:

Microbiology/Virology – Sendouts

Referred to:

Mayo Medical Laboratories (MML Test: 80574/PBORR)

Phone Numbers:

MIN Lab: 612-813-6280

STP Lab: 651-220-6550

Test Availability:

Daily, 24 hours

Turnaround Time:

1 – 4 days; Performed Monday-Saturday (June through November) and Monday-Friday (December through May)

Special Instructions:

Testing of CSF by PCR in patients with suspected Lyme neuroborreliosis should be requested only on patients with positive Borrelia burgdorferi antibody in serum confirmed by Western blot assay and with abnormal CSF findings (elevated protein and WBC >10 cells/high power field).

Specimen

Specimen Type:

Spinal (CSF) fluid or Synovial fluid
Note: Fresh Tissue will be accepted

Container:

Screw-capped sterile vial

Draw Volume:

1 mL (Minimum: 0. mL) CSF or Synovial Fluid
Fresh Tissue

Processed Volume:

Same as Draw Volume

Collection:

CSF/Synovial fluid collection

Tissue: 4 mm (Minimum: 3 mm) Skin or Synovial Biopsy in Sterile container with normal saline.
1. Submit only fresh tissue
2. Skin biopsies:
a. Wash biopsy site with antiseptic soap. Thoroughly rinse area with sterile water. Do not use alcohol or iodine preparations. A local anesthetic may be used.
b. Biopsy specimens are best taken by punch biopsy to include full thickness of dermis.
3. Label specimen with source tissue

Special Processing:

Lab Staff: Fluid specimen should be in a sterile, screw-capped plastic vial. Maintain sterility. Store at ship at refrigerated temperatures.

Patient Preparation:

None

Sample Rejection:

Mislabeled or unlabeled specimens

Interpretive

Reference Range:

Negative (reported as positive or negative)

Critical Values:

N/A

Limitations:

A negative result does not rule out Lyme disease, since inhibitory substances may be present in the specimen and the assay has limited diagnostic sensitivity when testing certain types of specimens. If clinical features of illness are highly indicative of Lyme neuroborreliosis, serologic testing on CSF is warranted.

Patients with active infection due to Borrelia afzelii, or Borrelia garinii may have positive results from this PCR test, which will be reported as atypical gene sequence and prompt additional testing. PCR test results should be used as an aid in diagnosis and not considered diagnostic by themselves. These results should be correlated with serologic and epidemiologic data and clinical presentation of the patient.

Concurrent infections with multiple tick-borne pathogens, including Erhlichia chaffeensis/Anaplasma phagocytophilum and/or Babesia microti have been reported in the United States, and consideration should be given to testing for other pathogens if clinically indicated.

Methodology:

Polymerase Chain Reaction (PCR)/DNA Probe Hybridization
(PCR is utilized pursuant to a license agreement with Roche Molecular Systems, Inc.)

References:

Mayo Medical Laboratories Web Page June 2013



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