LABORATORY DIAGNOSIS OF LYME BORRELIOSIS

Some direct methods that can be used for the diagnosis of Lyme borreli osis are the culture, direct visualization or the detection of microbi al DNA using polymerase chain reactions, in body tissues or fluids. Un fortunately, all these methods have a low sensitivity. There is a wide assortment of tests and antigens for indirect diagnosis, and the most recommended are ELISA tests and Western blot. The main inconvenient o f these tests are the existence of shared serologic reactions, the var iability of immune response and the difficult interpretation of result s. Therefore, we propose the following guidelines for the diagnosis of Lyme borreliosis: For sero-epidemiological studies and to diagnose in fection, antibodies should be determined in subjects with a compatible clinical picture, using an ELISA test that must be positive in at lea st two separate samples. All positive ELISA results should be confirme d with Western blot analysis, that must be interpreted using establish ed criteria. Polymerase chain reactions should be used when they are a vailable.