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Canadian Journal of Infectious Diseases
Volume 2, Issue 2, Pages 64-69
Consensus Conference on Lyme Disease

Laboratory Confirmation of Lyme Disease

Tom G Schwan,2 Warren J Simpson,1 and Patricia A Rosa2

1Arthropod-Borne Diseases Section, Laboratory of Vectors and Pathogens, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana, USA
2Laboratory of Microbial Structure and Function, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana, USA

Copyright © 1991 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Lyme disease can be confirmed in the laboratory by isolation or detection of its causative agent, a tick-borne spirochete Borrelia burgdorferi, or by a diagnostic change in the titre of antibodies specific to the agent. B burgdorferi can be isolated and cultivated in Barbour-Stoenner-Kelly II medium. It can be detected by light microscopy in tissue sections or, rarely, in blood smears using various staining methods. There is interest in the development of alternative detection methods, including identification of specific antigens of B burgdorferi in the urine of suspected cases and demonstration of the presence of species-specific DNA using polymerase chain reaction assays. Currently, serological tests (indirect immunofluorescence assay, enzyme-linked immunosorbent assay and Western immunoblot) are the most practical and available methods for confirming Lyme disease. The quest to improve the specificity and sensitivity of serological tests – for example, through the use of specific recombinant antigens – continues.