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

CPT4 code

Name of the Procedure:

Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique
Common name(s): Borrelia burgdorferi DNA/RNA test, Lyme Disease PCR Test

Summary

This test is designed to detect the genetic material (DNA or RNA) of Borrelia burgdorferi, the bacteria responsible for Lyme disease. It uses an amplified probe technique to identify the presence of the infection in a patient's sample, providing accurate and rapid results.

Purpose

The primary purpose of this procedure is to diagnose Lyme disease by detecting the presence of Borrelia burgdorferi. The goals are to confirm the infection quickly, enabling timely treatment to prevent chronic complications and spread of the disease.

Indications

  • Unexplained symptoms such as fever, headache, fatigue, and a characteristic skin rash known as erythema migrans.
  • A history of tick bites or exposure to areas known for Lyme disease.
  • Symptoms suggesting early or late-stage Lyme disease including joint pain, neurological problems, and heart palpitations.

Preparation

  • No specific fasting or dietary restrictions are required.
  • Patients should inform their healthcare provider about any medications they are taking, as certain treatments may need to be paused.

Procedure Description

  1. A healthcare provider will collect a sample from the patient, typically blood, but possibly cerebrospinal fluid, or tissue if necessary.
  2. The sample is processed to isolate DNA/RNA.
  3. A Polymerase Chain Reaction (PCR) amplified probe technique is then used to amplify the genetic material of Borrelia burgdorferi if it is present.
  4. The results are analyzed to confirm the presence or absence of the bacterial DNA/RNA.

Duration

The sample collection takes only a few minutes. Laboratory processing and analysis may take several hours to a few days, depending on the lab's capability and workload.

Setting

The procedure can be performed in an outpatient clinic, a doctor’s office, or a hospital laboratory.

Personnel

  • A nurse or phlebotomist to collect the sample.
  • Laboratory technicians to analyze the sample.
  • A doctor or specialist to interpret the results and discuss them with the patient.

Risks and Complications

  • Minimal risks associated with sample collection (e.g., slight pain or bruising at the collection site).
  • Rarely, similar symptoms might lead to a false-positive or false-negative result, necessitating follow-up tests.

Benefits

  • Quick and accurate diagnosis of Lyme disease.
  • Helps initiate appropriate treatment early, reducing the risk of severe complications.
  • Peace of mind for patients through confirmation or exclusion of Lyme disease.

Recovery

  • There is no recovery time required after the sample collection.
  • Patients can resume normal activities immediately after the sample is taken.
  • Follow-up appointments may be necessary based on the test results.

Alternatives

  • Serological tests such as ELISA and Western blot, which detect antibodies against Borrelia burgdorferi.
    • Pros: Non-invasive, widely available.
    • Cons: May not detect early infections, requires confirmation with additional tests.

Patient Experience

  • Patients might feel a slight pinch during blood draw or sample collection but otherwise should experience minimal discomfort.
  • Following the procedure, patients can expect normal daily activities without restrictions.

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