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Lyme Disease Test

Last updated July 25, 2019

Approved by: Maulik P. Purohit MD, MPH

Lyme disease is caused by the bacterium Borrelia burgdorferi. It is transmitted to humans through the bite of infected deer ticks or black-legged ticks.

What are the other Names for this Test? (Equivalent Terms)

  • Borrelia Burgdorferi Antibodies Test
  • Lyme Antibodies Detection Test
  • Lyme Disease by PCR Test

What is Lyme Disease Test? (Background Information)

  • Lyme disease is caused by the bacterium Borrelia burgdorferi. It is transmitted to humans through the bite of infected deer ticks or black-legged ticks
  • The first antibody produced in response to the infection is IgM. It may take 2-3 weeks to appear, after an exposure to the bacterium. IgM levels peak at about 6 weeks and thereafter, they start to decline
  • IgG antibodies appear later, peak at 4-6 months and may remain detectable in the body, for several years
  • The Lyme Disease Test looks for the presence of antibodies to B. burgdorferi in the blood/cerebrospinal fluid/joint fluid (synovial fluid) of the infected individuals
  • The Centers for Disease Control and Prevention (CDC) has laid down a two-step testing process:
    • The first is an ELISA (enzyme linked immunosorbent assay) or IFA (immunofluorescence assay) to measure IgM and/or IgG antibodies, against the bacteria
    • A positive ELISA/IFA is further investigated using a western blot test (a test performed to look for a particular protein in a test sample) for confirmation
  • A PCR (polymerase chain reaction) test to look for DNA of Borrelia burgdorferi may also be conducted on joint fluid samples

What are the Clinical Indications for performing the Lyme Disease Test?

A physician may order Lyme Disease Testing in an individual:

  • Presenting with signs and symptoms suggestive of Lyme disease
  • And with a history of residence or a visit to an area, where Lyme disease is prevalent; with/without a definitive history of tick bites

The early symptoms of Lyme disease include:

  • A “bull’s eye” rash, which it spreads out from the site of the tick bite
  • Fevers, chills
  • Headache
  • Fatigue

During the later stages, Lyme disease may cause:

  • Joint pain
  • Meningitis - inflammation of the lining of the brain and spinal cord
  • Bell’s palsy (facial paralysis)
  • Arm and leg weakness and numbness
  • In rare cases, heart problems

How is the Specimen Collected for Lyme Disease Test?

Sample required:

  • Blood
  • Cerebrospinal fluid, in cases of nervous system involvement
  • Joint (synovial) fluid


  • Blood sample is obtained through a needle inserted into a vein, in the arm
  • Cerebrospinal fluid (CSF) is obtained through a lumbar puncture; where a needle is inserted in the lower back, into a CSF-filled space, called the subarachnoid space, surrounding the spinal cord
  • Synovial fluid is obtained through a needle inserted into the joint space

Preparation required: None

What is the Significance of the Lyme Disease Test Result?

A Lyme Disease Test may have the following outcomes:

  • Negative for IgM and IgG antibodies: The individual is either not infected, or the antibody levels are too low; repeat testing may be done few weeks later
  • Positive for IgM antibodies and negative for IgG and western blot: Indicates a recent infection or a false positive result (i.e. a positive test result, but without any infection by Borrelia burgdorferi)
  • Negative for IgM, but positive for IgG and western blot: Indicates late infection, or an infection in the past
  • Positive for IgM, IgG, and western blot: Indicates a likelihood of Lyme disease

PCR test result:

  • A positive PCR test (polymerase chain reaction test) indicates a recent Borrelia burgdorferi infection
  • A negative PCR may either be, due to an absence of infection, or due to low levels of the bacterial DNA

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario.

Additional and Relevant Useful Information:

  • A false positive result, in the absence of Lyme disease, may occur in infections, such as syphilis, leptospirosis, HIV, mononucleosis, or with some autoimmune disorders

Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider, the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: March 2, 2014
Last updated: July 25, 2019