These symptoms may be brief, only to recur as a broader spectrum of symptoms as the disease progresses. The more severe, potentially debilitating symptoms of later-stage LD may occur weeks, months, or, in a few cases, years after a tick bite. There is no test that can determine if a patient is infected with the LD bacterium and then demonstrate that the patient has become bacterium-free. Therefore, LD is clinical diagnosis, based on signs and symptoms, with the patients travel history to endemic areas and test results being additional pieces of information in the complete picture. These tests measure the level of Bb antibodies in fluid.
Laboratories use different detection criteria, cut-off points, types of measurements, and reagents.
Western blot - This test produces bands indicating the immune system's reactivity to Bb . This may be useful for detecting LD in patients taking antibiotics or during symptom flare-up. This test multiplies the number of Bb DNA to a detectable measurable level. Culturing - Growing the bacterium in culture is difficult and can take months. Staining - Staining of tissue is time consuming and has low yield.