Diagnosis of Lyme Disease

Diagnosis of Lyme disease is made based on clinical symptoms and case history. In cases of early stage disease, known exposure, and symptoms that suggest later stage disease, laboratory testing may support a diagnosis.

Laboratory Tests to Diagnose Lyme Disease

First, enzyme-linked immunosorbent assay (ELISA) or immunofluorescent assay is performed on a blood sample to identify Borrelia burgdorferi and antibodies to the bacteria. If there is a positive result, it may be confirmed using the Western blot test, which can detect small amounts of antibodies.

Positive results may be seen years after a successfully treated infection or an infection that resolved on its own. A positive result does not necessarily indicate active infection.

Ticks can be tested for bacteria. The tick should be removed carefully with fine tweezers, grabbing it as close to the skin as possible, and placed in a clean container with a moistened cotton swab. Squeezing the tick or applying petroleum jelly, a burnt match, or alcohol can transmit the bacteria and should be avoided.

Publication Review By: John J. Swierzewski, D.P.M.

Published: 31 Dec 1999

Last Modified: 13 Aug 2015