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Test ID: TKPNL Tick-Borne Panel, Molecular Detection, PCR, Blood

Useful For

Evaluation of patients with suspected human monocytic ehrlichiosis, human granulocytic anaplasmosis, babesiosis, or Borrelia miyamotoi infection

 

Evaluation of patients with a history of, or suspected, tick exposure who are presenting with fever, myalgia, headache, nausea, and other nonspecific symptoms

Profile Information

Test ID Reporting Name Available Separately Always Performed
LBAB Babesia species, PCR, B Yes Yes
EHRL Ehrlichia/Anaplasma PCR, B Yes Yes
BMIYB Borrelia miyamotoi Detection PCR, B Yes Yes

Testing Algorithm

See Acute Tick-Borne Disease Testing Algorithm in Special Instructions.

Method Name

Real-Time Polymerase Chain Reaction (PCR)/DNA Probe Hybridization

Reporting Name

Tick-Borne DNA Panel, B

Specimen Type

Whole Blood EDTA


Specimen Required


Container/Tube: Lavender top (EDTA)

Specimen Volume: 1 mL


Specimen Minimum Volume

0.3 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Whole Blood EDTA Refrigerated 7 days

Clinical Information

Ticks are the primary vectors of infectious diseases in North America, and rank second only to mosquitoes in disease transmission worldwide. In the United States, tick-borne diseases include Lyme disease, Rocky Mountain spotted fever, human monocytic ehrlichiosis, human granulocytic anaplasmosis, babesiosis, tularemia, relapsing fever, Colorado tick fever, and Borrelia miyamotoi infection.(1) Several of these diseases are transmitted by the same tick, and coinfections are occasionally seen. In particular, Ixodes species ticks are capable to transmitting the causative agents of Lyme disease (B burgdorferi and B mayonii), anaplasmosis (Anaplasma phagocytophilum), and babesiosis (Babesia species). These diseases are prevalent throughout the northeastern and upper Midwestern states and parts of the Pacific Northwest.

 

Symptoms of the various tick-vectored diseases range from mild to life-threatening. Early symptoms, which include fever, aches, and malaise, do not aid in distinguishing the various diseases. Because early treatment can minimize or eliminate the risk of severe disease, early detection is essential, yet patients may not have developed distinctive symptoms to help in the differential diagnosis. A rapid tick-borne PCR panel can assist in identifying the pathogen, allowing treatment to be initiated.

 

While Lyme disease due to B burgdorferi is best detected through 2-tiered serologic testing, acute ehrlichiosis, anaplasmosis, babesiosis, and B miyamotoi infection are best detected using molecular amplification assays. This tick-borne panel offers sensitive, specific, and rapid detection of the agents that cause these 4 diseases.

 

For information on the specific diseases, see the individual test IDs.

Reference Values

Babesia species, MOLECULAR DETECTION, PCR

Negative

 

Ehrlichia/Anaplasma, MOLECULAR DETECTION, PCR

Negative

 

Borrelia miyamotoi, MOLECULAR DETECTION, PCR

Negative

Interpretation

Borrelia miyamotoi: 

A positive result indicates the presence of B miyamotoi DNA and is consistent with active or recent infection. While positive results are highly specific indicators of disease, they should be correlated with symptoms and clinical findings of tick-borne relapsing fever.

 

Ehrlichia/Anaplasma: 

Positive results indicate presence of specific DNA from Ehrlichia chaffeensis, E ewingii, E muris eauclairensis, or A phagocytophilum and support the diagnosis of ehrlichiosis or anaplasmosis.

 

Negative results indicate absence of detectable DNA from any of these 4 pathogens in specimens, but it does not exclude the presence of the organism or active or recent disease.

 

Since DNA of E ewingii is indistinguishable from that of E canis by this rapid PCR assay, a positive result for E ewingii/canis indicates the presence of DNA from either of these 2 organisms.

 

Babesia: 

A positive result indicates the presence of Babesia species DNA and is consistent with active or recent infection. While positive results are highly specific indicators of disease, they should be correlated with blood smear microscopy, serological results and clinical findings.

 

A negative result indicates absence of detectable DNA from Babesia species in the specimen, but does not always rule-out ongoing babesiosis in a seropositive person, since the parasitemia may be present at a very low level or may be sporadic.

 

Other tests to consider in the evaluation of a patient presenting with an acute febrile illness following tick exposure include serologic tests for Lyme disease (B burgdorferi), and molecular detection (PCR) for ehrlichiosis/anaplasmosis. For patients who are past the acute stage of infection, serologic tests for these organisms should be ordered prior to PCR testing.

Clinical Reference

Caulfield AJ, Pritt BS: Lyme Disease Coinfections in the United States. Clin Lab Med 2015;35(4):827-846

Day(s) Performed

Monday through Saturday

Report Available

Same day/1 to 4 days

Test Classification

See Individual Test IDs

CPT Code Information

87798 x 8

LOINC Code Information

Test ID Test Order Name Order LOINC Value
TKPNL Tick-Borne DNA Panel, B In Process

 

Result ID Test Result Name Result LOINC Value
84319 Anaplasma phagocytophilum 87558-3
36114 Babesia microti 88452-8
64970 B. miyamotoi PCR, B 82475-5
36115 Babesia duncani 88451-0
23663 Ehrlichia chaffeensis 87559-1
23664 Ehrlichia ewingii/canis 87560-9
36116 Babesia divergens/MO-1 88450-2
32010 Ehrlichia muris eauclairensis 87561-7

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-General Request (T239)

-Microbiology Test Request (T244)

Mayo Clinic Laboratories | Microbiology and Infectious Disease Catalog Additional Information:

mml-tickborne