Lyme disease how is it diagnosed

Section Navigation. Facebook Twitter LinkedIn Syndicate. Diagnosis and Testing. Minus Related Pages. Working with CDC, NIAID plays a major role in encouraging the development of new approaches to improve Lyme disease diagnosis in people with tick-borne co-infections such as anaplasmosis or babesiosis.

New diagnostic tests are also needed to distinguish between people with B. Although Lyme disease vaccines for humans are no longer available in the United States, the discontinued LYMErix vaccine used between and was based on a specific part of B. In response to the vaccines, immunized individuals developed antibodies for OspA.

Because the conventional ELISA measures OspA antibodies to determine if someone has Lyme disease, the test does not provide accurate results for immunized individuals. People who received the vaccination will test positive whether or not they are actually infected with B.

Department of Health and Human Services federal research on tickborne disease diagnostics. Greater advances in diagnostics are anticipated as genetic information is combined with advances in microarray technology, imaging, and proteomics. These growing fields of science are expected to lead to improved diagnostic tools as well as provide new insights on the pathogenesis of Lyme disease.

Examples of tools being developed with NIAID support include use of metabolomics to characterize new biomarkers of infection, next generation T-cell based measurements, and novel antigens for improved measurement of effective treatment. Organization History. Diagnosis and Testing. Data and Statistics. Preventing Tick Bites. Tick Removal and Testing. Post-Treatment Lyme Disease Syndrome. Health Care Providers.

Educational Materials. Why is CDC concerned about Lyme disease? Different radiopharmaceuticals allows us to measure different aspects of brain function. For example, the most widely used "tracer" for measuring regional brain blood flow is 15O-labeled water. Because the radioactive tracer used for FDG PET scans is stable over many hours, PET scans in clinical settings typically assess metabolism directly through monitoring of glucose function rather than blood flow.

One way of determining whether the brain blood vessels are functioning normally is to conduct a 15O-PET before and after a carbon dioxide inhalation challenge. The patient is then asked to breathe through a tube that contains a slightly higher amount of carbon dioxide than the normal atmosphere. In a person with normal blood vessels, this should result in an expansion of blood flow throughout the brain.

If certain areas have damaged blood vessels, then the expansion of flow in that area would be less. This is one way of determining whether the problem in a disease such as Lyme encephalopathy is due to inflamed or blocked small blood vessels or due to normal blood vessels with abnormal nerve input.

Because this carbon dioxide inhalation challenge however is not routinely available in the clinical setting, an approximation may be obtained by using the medicine acetazolamide. Positron Emission Tomography PET , although primarily a research tool, has been used increasingly for clinical purposes.

PET imaging can demonstrate biochemical or physiological processes involved in brain metabolism. The assumption behind all functional brain imaging such as PET is that there is a close relationship between local brain nerve activity, brain glucose metabolism, and brain blood flow. The advantage of PET in comparison to SPECT is that the images have enhanced resolution and, in research settings, with the use of an arterial line, absolute quantification of the metabolism and flow in different brain areas is possible.

In other words, unlike SPECT which requires assumptions about normal and abnormal brain areas for interpretation, PET can provide a definitive absolute number regarding the amount of flow or metabolism in a particular area of the brain.

Because a PET center requires a highly trained multidisciplinary staff of physicists, chemists, computer and mathematical experts, technologists, and physicians as well as a cyclotron in the same building as the patient and the scanner to allow for production of the radiopharmaceuticals, PET scans are more expensive and far less widely available than SPECT scans. If this finding is confirmed by further study, then PET scans may emerge as a very helpful clinical tool in differential diagnosis.

Electromyography EMG and nerve conduction studies assess the integrity and function of muscle and nerve, respectively. The EMG test allows the neurologist to distinguish neuropathic from myopathic disease and define the precise distribution of muscle involvement. NCS assist in the diagnosis of nerve disorders, such as demyelinating neuropathy slow conduction velocity , axonal neuropathy reduced amplitude of CMAP , and root compressions.

Lyme disease can cause a neuropathy with associated sensory symptoms and sensory loss. To detect small-fiber damage, skin biopsies are now being performed in many diseases that cause neuropathies.

IENF density is a general marker of axonal integrity in peripheral neuropathies, but it cannot be used to make a specific diagnosis. Recently, neurologists have begun to examine patients with Lyme disease to assess small nerve fiber density. Since subjective reports of cognitive difficulties, such as memory problems, do not always correlate with objective data, we cannot rely only on self-reported cognitive problems. The sensitivity of neuropsychological tests in identifying brain dysfunction is high, though the test deficits are not specific to Lyme disease.