87475 Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique

Name of the Procedure:

Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique.

Summary

This procedure identifies the presence of Borrelia burgdorferi, the bacterium responsible for Lyme disease, using a direct probe technique to detect its DNA or RNA in a patient's sample.

Purpose

The primary goal of this procedure is to diagnose Lyme disease by detecting the genetic material of Borrelia burgdorferi. Early and accurate diagnosis can lead to more effective treatment and better patient outcomes.

Indications

• Patients presenting with symptoms consistent with Lyme disease, such as a bullseye rash, flu-like symptoms, fatigue, and joint pain.
• Individuals with a known tick bite history, especially in regions where Lyme disease is common.
• Unexplained neurological, cardiac, or joint abnormalities where Lyme disease is a differential diagnosis.

Preparation

• There are generally no specific preparations required for the patient.
• Patients should inform their healthcare provider of any medications they are taking.
• Relevant medical history and physical examination will be conducted prior to the test.

Procedure Description

1. A sample, often blood or cerebrospinal fluid, is collected from the patient.
2. The sample is treated in the lab to extract the nucleic acids (DNA or RNA) of any pathogens present.
3. A direct probe specific to Borrelia burgdorferi is applied to the sample.
4. If the bacterium's DNA or RNA is present, the probe will bind to it and produce a detectable signal.

The technique involves the use of molecular biology tools and reagents, but no anesthesia or sedation is required for this procedure.

Duration

The sample collection typically takes a few minutes. Laboratory analysis may take several hours to a few days, depending on the urgency and laboratory capabilities.

Setting

• The sample collection is often done in a doctor's office, clinic, or hospital.
• The actual nucleic acid detection is performed in a specialized laboratory.

Personnel

• Sample collection can be done by a nurse or phlebotomist.
• Laboratory technologists or molecular biologists perform the DNA/RNA analysis.

Risks and Complications

• The main risk comes from the sample collection, such as minor discomfort or bruising at the blood draw site.
• Rare risks include infection where the needle is inserted.

Benefits

• Accurate and early detection of Borrelia burgdorferi.
• Allows for timely treatment, reducing the risk of chronic Lyme disease symptoms.

Recovery

• There is no specific recovery period needed after the sample collection.
• Patients can resume normal activities immediately after.

Alternatives

• Serological testing for Lyme disease (e.g., ELISA, Western Blot).
• Clinical diagnosis based on symptoms and medical history, especially in the absence of lab confirmation.

Pros and Cons:

• Direct probe technique provides specific identification of Borrelia burgdorferi’s DNA/RNA but can be more labor-intensive and expensive.
• Serological tests can indicate exposure to Lyme bacteria but may not distinguish between current and past infections.

Patient Experience

Patients might experience minor discomfort during the sample collection process. Post-procedure, there is generally no significant pain or discomfort. Any minor side effects, such as slight bruising, typically resolve quickly.