I had a titer test on Saturday for Lyme disease. Today (Monday) the doctor's office called back with, I guess, the results. I wasn't home and now the office is closed. Would quick results like this (and such a quick phone call) indicate either positive or negative?
As background, well, we have two golden retrievers and live on a few wooded acres in Virginia. We often see tics and one of my goldens tested positive for Lyme many months ago. Exactly three months ago I was bit by a tic - it must have been in my stomach overnight. Then it swelled unbelievably and has remained irritated, swollen and itchy. Anyhow, this last week I've developed fever, sore throat and painful joints. I had an appointment with my migraine doctor last Friday who thought she saw a bulletseye and sent me to my primary care on Saturday.
At this point I feel terrible and am actually hoping for a positive result so I can get it taken care of - and know why I feel so terrible! Just wondering why they called so quickly - if that would give any indication as to the result.
As far as the office calling, it depends on the office and what their policy is on reporting test results, but most offices only call if there is a positive.
Do be aware of certain things, however.
The presence of an erythema migrans, or the "bullseye" rash, indicates Lyme disease. In other words, if you have the em, you have Lyme. The em does not always take on the bullseye form, it can resemble a line or a bruise, it can be small or large, it may or may not swell or itch, there may be multiple rashes, it may be raised, etc. If you have a rash it is strongly recommended that you photograph it, and include something such as a coin or ruler in the picture to indicate the size of the rash. This could be important for later diagnostic purposes.
Over 50% of people with Lyme never get any rash at all. Many do not even recall a tick bite.
There is NO test that can absolutely rule out Lyme disease. People who have Lyme disease can test negative. For this reason the CDC states that Lyme is to be a clinical diagnosis with testing used to help confirm. The most commonly done test, the ELISA (titer) misses up to 60% or more of active infections. The Western Blot, the more accurate test, is not generally used unless someone gets a positive ELISA (go figure out the logic of that!). In a study done for the Lymerix vaccine, which involved thousands of patients with culture-proven Lyme, 30% never developed a positive Western Blot.
Unfortunately, the medical community still has a lot to learn about Lyme and tick borne diseases, and many are still treating with outdated protocols. In addition to Lyme, ticks carry a variety of co-infections including Babesiosis, Bartonella, Erlichiosis (HGE & HME), mycoplasma, just to name a few. Many people with Lyme also have one or more co-infections. It is vital that co-infections be treated. These co-infections do exist in the Virginia area, and I know quite a few people who are infected.
Should I ask for an antibiotic even though results negative?
It's me again; the desk nurse said the test results were negative. Should I ask for an antibiotic in any case, to be safe? I haven't been prescribed one in years for anything, so there's no overuse and I do feel achy and flulike (and irritable!).
How long after being bit was the blood sample taken? The test is for antibodies, and it takes several weeks for the body to produce measureable amounts of antibodies. Again, bear in mind that the titer or ELISA test is highly inaccurate.
If you have had an erythema migrans, and if so I hope you photographed it, you have Lyme. The presence of the rash is in itself grounds for treatment.
The dosage recommended by Lyme authorities is 400-600 mgs of doxycycline for 6 weeks. This is if the infection is caught within two weeks of the bite. Longer infections require further treatment. The life cycle of the Lyme organism, Borrelia burgdorferi, is 4 weeks, and it takes a minimum of 4 weeks to kill one cycle of the organisms. Symptoms can subside after a shorter course, as the bacteria delve further into body tissues, and the illness can appear to "go away". Meanwhile it is in fact dormant in the body, only to reemerge later with horrendous consequences.
As for overusage, I personally believe there is far more overusage in beef cattle, etc. than there is in humans. The worst case scenario you'd have taking the antibiotics (barring an allergic reaction) is an upset stomach. The possibilities of not taking them is a devastating and chronic disease.
Re: Should I ask for an antibiotic even though results negative?
Hi Melissa, welcome to the board!
As was posted, a bullseye rash is a definite sign of Lyme disease. The rash alone merits treatment. Flu-like symptoms in the summer should be suspect of Lyme. If you still have the rash or if it comes back, get photos of it.
It is very important to see a knowledgeable doctor and be tested for the co-infections. Many doctors do not understand Lyme and treat with outdated protocols. The sooner you can get the proper treatment, the better. Getting the proper treatment early in the infection may reduce the chance of long-term complications. I know of one Lyme doctor in Fairfax. If you would like the name, let me know.