Specimen:

CSF

Collection Medium:

Alternate
Collection Media:

CSF container

Minimum:

Adult preferred minimum: 3 mL CSF
Adult absolute minimum: 0.5 mL CSF
Pediatric minimum: 0.3 mL CSF

Analytic Time:

3 working days

Reference Range:

0.99 LIV: Negative - Antibody to Borrelia 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
                     Borrelia burgdorferi detected.

Comments:

*** Serum testing for Lyme Antibody (Borrelia burgdorferi) should be 
sent to Clinical Microbiology, 6004 BT.

Note - Once this test is performed, if:
  a) Negative - no further testing is done.
  b) Positive or equivocal - Western blot testing will be performed on
     the original sample upon receiving a request. Sample will be held
     for 30 days only.

Test
Limitations:

LIV = Lyme Index Value

The detection of antibodies to Borrelia burgdorferi in CSF 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 Western blot.  Both IgM and IgG Western blots 
should be performed on samples less than eight weeks after appearance 
of erythema migrans.  Only IgG Western blot should be performed on 
samples greater than eight weeks after the disease onset.  IgM Western 
blot 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 Western blot testing within 10 days.

Methodology:

Enzyme-Linked Immunosorbent Assay

CPT Code:

86618

See also:
Borrelia burgdorferi Antibodies (Lyme) IgG & IgM, Serum