Diagnostic Highlights


Normal Result

Abnormality with Condition


Enzyme-linked immunosorbent assay (ELISA)

IgG Western blot

Nonreactive Negative

Levels of specific IgM antibodies peak during the 3rd to 6th wk after onset and then gradually decline

Presence of antibodies; positive test with 5-10 bands of antibodies present

Measures levels of specific IgM antibodies

Immunoassay that allows visualization of IgG antibodies to a spirochete, Borrelia burgdorferi, the agent of Lyme disease; more sensitive than ELISA

Other Tests: Culture from skin lesions (Impractical and rarely performed)

Note: Patients may remain seropositive for long periods and the enzyme-linked immunosorbent assay (ELISA) test cannot be used as a proof of cure. A negative lyme test result does not indicate the absence of disease, nor does a positive result indicate the presence of disease. A positive result is not required to diagnose Lyme disease for someone with clear-cut erythema migrans, and those patients should be treated regardless of test results.

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