Test Code LYMPV Lyme Disease, Molecular Detection, PCR, Varies
Ordering Guidance
This assay does not detect Borrelia miyamotoi. If infection with this organism is suspected, order BMIPB / Borrelia miyamotoi Detection, PCR, Blood or BMIYC / Borrelia miyamotoi Detection, PCR, Spinal Fluid.
Necessary Information
Specimen source is required.
Specimen Required
Submit only 1 of the following specimens:
Specimen Type: Spinal fluid
Container/Tube: Sterile vial
Specimen Volume: 1 mL
Collection Instructions: Label specimen as spinal fluid.
Specimen Type: Synovial fluid
Container/Tube: Sterile vial
Specimen Volume: 1 mL
Collection Instructions: Label specimen as synovial fluid.
Specimen Type: Tissue (fresh only)
Sources: Skin or synovial biopsy
Container/Tube: Sterile container with normal saline
Specimen Volume: Approximately 4 mm(3)
Collection Instructions:
1. Submit only fresh tissue.
2. Skin biopsies:
a. Wash biopsy site with an 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 of tissue.
Useful For
Supporting the diagnosis of Lyme disease in conjunction with serologic testing
Specific indications including testing skin biopsies when a rash lesion is not characteristic of erythema migrans and testing synovial fluid or synovium to support the diagnosis of Lyme arthritis
This test should not be used to screen asymptomatic patients.
Testing Algorithm
The following algorithms are available:
Special Instructions
Method Name
Real-Time Polymerase Chain Reaction (PCR)/DNA Probe Hybridization
Reporting Name
Lyme Disease, PCR, VariesSpecimen Type
VariesSpecimen Minimum Volume
Spinal Fluid: 0.3 mL; Synovial Fluid: 0.5 mL; Tissue: See Specimen Required
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Varies | Refrigerated (preferred) | 7 days | |
Frozen | 7 days |
Reference Values
Negative
Reference values apply to all ages.
Interpretation
A positive result indicates the presence of DNA from Borrelia burgdorferi, Borrelia mayonii, Borrelia afzelii, or Borrelia garinii, the main agents of Lyme disease.
A negative result indicates the absence of detectable target DNA in the specimen. Due to the clinical sensitivity limitations of the polymerase chain reaction assay, a negative result does not preclude the presence of the organism or active Lyme disease.
Clinical Reference
1. Stanek G, Wormser GP, Gray J, Strle F: Lyme borreliosis. Lancet. 2012 Feb;379(9814):461-473
2. Pritt BS, Mead PS, Johnson DK, et al: Identification of a novel pathogenic Borrelia species causing Lyme borreliosis with unusually high levels of spirochetemia: a descriptive study. Lancet Infect Dis. 2016 May;16(5):556-564
3. Pritt BS, Respicio-Kingry LB, Sloan LM, et al: Borrelia mayonii sp. nov., a member of the Borrelia burgdorferi sensu lato complex, detected in patients and ticks in the upper midwestern United States. Int J Sys Evol Microbiol. 2016 Nov;66(11):4878-4880
4. Hinckley AF, Connally NP, Meek JI, et al: Lyme disease testing by large commercial laboratories in the United States. Clin Infect Dis. 2014 Sep;59(5):676-681
5. Lindgren E, Jaenson TGT: Lyme borreliosis in Europe: influences of climate and climate change, epidemiology, ecology and adaptation measures. World Health Organization; 2006
6. Centers for Disease Control and Prevention. Recommendations for test performance and interpretation from the Second National Conference on Serologic Diagnosis of Lyme Disease. MMWR Morb Mortal Wkly Rep. 1995 Aug;44(31):590-591
7. Babady NE, Sloan LM, Vetter EA, et al: Percent positive rate of Lyme real-time polymerase chain reaction in blood, cerebrospinal fluid, synovial fluid, and tissue. Diagn Microbiol Infect Dis. 2008 Dec;62(4):464-466
8. Centers for Disease Control and Prevention (CDC). Lyme disease--United States, 1995. MMWR Morb Mortal Wkly Rep. 1996 Jun;45(23):481-484
Day(s) Performed
June through November: Monday through Saturday
December through May: Monday through Friday
Report Available
Same day/ 1 to 4 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterTest Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
87476
87798 x 2
87999 (if appropriate for government payers)
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
LYMPV | Lyme Disease, PCR, Varies | 94253-2 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
LYMS | Specimen Source | 31208-2 |
618333 | B. burgdorferi PCR | 94250-8 |
618334 | B. mayonii PCR | 94251-6 |
618335 | B. garinii/B. afzelii PCR | 94252-4 |
618336 | Lyme CSF Comment | 59464-8 |
Forms
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.