Blood smears or tissue specimen slide preparations are stained and examined microscopically for the presence of malaria (Plasmodium), Babesia, Leishmania, trypanosomes, Toxoplasma and microfilaria.

This test is approved for New York patient testing.

• Total T and B Cells

• Blood and Tissue Parasite Detection, LM

This unit code has been inactivated.

Please see unit code 55335.

Babesia microti DNA PCR is a highly specific and sensitive method to detect the presence of B. microti DNA in clinical specimens; DNA sequences from the closely related canine pathogen B. gibsoni are not detected by this assay.

This test is not approved for New York patient testing.

Human babesiosis is transmitted by the bite of an infected Ixodes tick or less frequently by transfusion with blood from an infected donor. Definitive diagnosis is made by identifying intraerythrocytic organisms in peripheral blood. In patients with low parasitemia, antibody detection by IFA is recommended. IgG levels >=1:1024 can be detected in acute phase patients with parasites in blood smears. The IFA procedure can be used as a seroepidemiologic tool to study the frequency and distribution of B. microti in endemic areas, especially in persons with mixed infections also involving Borrelia burgdorferi. IgM antibody levels indicate an acute phase infection. Focus suggests parallel detection of parasites on blood smears for definitive diagnosis.

†This test was developed and its performance characteristics determined by Focus Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. Performance characteristics refer to the analytical performance of the test.

This test is approved for New York patient testing.

See individual assay for description.

Panel includes:

• Babesia microti IgG and IgM Antibody, IFA
• Borrelia burgdorferi IgG and IgM Antibody, IFA

• WA1 IgG Antibody, IFA

• Bacterial Culture, Aerobic, Special
• Bartonella Species Antibodies (IgG, IgM) with Reflex to Titer

See individual assay for description.

Panel Includes:

• Haemophilus influenzae type b Antigen Detection, LA
• Neisseria meningitidis Antigen Detection (Groups A/Y and C/W 135), LA
• Neisseria meningitidis Detection (Group B/E. coli K1), LA
• Streptococcus, Group B, Antigen Detection, LA
• Streptococcus pneumoniae Antigen Detection, LA

Water, soil, or other environmental samples are cultured using appropriate growth media for the isolation of bacterial species. Cultures are performed by standard reference microbiological procedures. Identification of the predominant organism is provided, and a charge will be added for each additional identification.
Not for Clinical Specimens.

This test is approved for New York patient testing.

Culture includes the identification of the predominant organism or pathogen. A charge will be added for each additional identification. Serotyping of select species is available for an additional charge.

This test is approved for New York patient testing.

All cultures are performed by standard reference microbiological procedures. Routine specimens other than stool (e.g., throat, sputum, urine, blood, etc.) are included. Culture includes the identification of the predominant organism or pathogen. A charge will be added for each additional identification. Serotyping of select species is available for an additional charge.

This test is approved for New York patient testing.

Culture includes the identification of the predominant organism or pathogen. A charge will be added for each additional identification. Serotyping of select species is available for an additional charge.

This test is approved for New York patient testing.

Please indicate suspected organism(>s) when submitting specimen.

Bartonella spp. Brucella spp. Corynebacterium diphtheriae Haemophilus ducreyii Listeria monocytogenes

Neisseria gonorrhoeae Streptobacillus moniliformis Vibrio spp. Yersinia pestis Other

Culture includes the identification of the predominant organism or pathogen. Serotyping of select species is available for an additional charge.

This test is approved for New York patient testing.

Please indicate suspected organism(>s) when submitting specimen.

Bartonella spp. Brucella spp. Corynebacterium diphtheriae Haemophilus ducreyii Listeria monocytogenes

Neisseria gonorrhoeae Streptobacillus moniliformis Vibrio spp. Yersinia pestis Other

Culture includes the identification of the predominant organism or pathogen. Serotyping of select species is available for an additional charge.

This test is approved for New York patient testing.

Culture includes the identification of the predominant organism or pathogen. A charge will be added for each additional identification.

This test is approved for New York patient testing.

Culture includes the identification of the predominant organism or pathogen. A charge will be added for each additional identification.

This test is approved for New York patient testing.

A standard number of enterococci isolated from stool on non-selective media is inoculated onto Brain Heart Infusion (BHI) agar containing 6 mcg/mL of vancomycin. After incubation, the appearance of growth indicates that the enterococcal isolate is presumptively resistant to vancomycin. This screen plate does not determine the level of vancomycin resistance or the vancomycin phenotype. An MIC will be performed upon request for an additional charge. Any presumptive VRE isolated will be identified to species.

This test is approved for New York patient testing.

Bacterial isolates will be identified using biochemical and microbiological methods. An additional charge will be added for each additional identification. Serotyping of select species is available for an additional charge.

This test is approved for New York patient testing.

Bacterial isolates recovered from environmental sources will be identified using conventional biochemical and microbiological methods. An additional charge will be added for each additional identification.

This test is approved for New York patient testing.

Bacterial isolates will be identified using biochemical and microbiological methods. An additional charge will be added for each additional identification.

This test is approved for New York patient testing.

The most common Bartonella infection is cat scratch disease. The detection of Bartonella henselae and Bartonella quintana DNA is based upon the real-time amplification of specific Bartonella genomic DNA sequences. Probes specific for B. henselae and B. quintana are used to identify and differentiate the species.

This test is not approved for New York patient testing.

Infection with Bartonella henselae has been associated with cat scratch disease, bacillary angiomatosis, peliosis hepatis, and bacteremia. If Bartonella henselae screen is positive, an IgG ad IgM titer will be performed at an additional charge.

†This test was developed and its performance characteristics determined by Focus Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. Performance characteristics refer to the analytical performance of the test.

This test is approved for New York patient testing.

This unit code has been inactivated.

Please see unit code 40881.

See individual assay for description.

Panel includes:

• Bartonella henselae Antibodies
• Bartonella quintana Antibodies

This test is approved for New York patient testing.

See individual assay for description.

Panel includes:

• Bartonella henselae Antibody Panel (CSF)
• Bartonella quintana Antibody Panel (CSF)

Infection with Bartonella henselae has been associated with cat scratch disease, bacillary angiomatosis, peliosis hepatis, and bacteremia. Infection with Bartonella quintana has been associated with trench fever and bacillary angiomatosis in both HIV positive and negative individuals. IgG crossreactivity between B. henselae and B. quintana may occur.

†This test was developed and its performance characteristics determined by Focus Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. Performance characteristics refer to the analytical performance of the test.

This test is approved for New York patient testing.

Detection of intrathecally-produced organism-specific antibodies in CSF indicates central nervous system infection. However, serum levels of organism-specific antibodies, blood-brain barrier integrity, and possible CSF contamination by blood should be considered when assessing CSF results.

†This test was developed and its performance characteristics determined by Focus Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. Performance characteristics refer to the analytical performance of the test.

This test is not approved for New York patient testing.

Bartonella henselae or Bartonella quintana IgM titers of 1:20 or higher have not been detected in the normal adult population, and are thus highly specific for recent Bartonella infection. Crossreactivity of IgM between the two species is limited and typically is not seen. Infection with Bartonella henselae has been associated with cat scratch disease, bacillary angiomatosis, peliosis hepatis, and bacteremia. Infection with Bartonella quintana has been associated with trench fever and bacillary angiomatosis in both HIV positive and negative individuals.

†This test was developed and its performance characteristics determined by Focus Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. Performance characteristics refer to the analytical performance of the test.

This test is approved for New York patient testing.

Detection of intrathecally-produced organism-specific antibodies in CSF indicates central nervous system infection. However, serum levels of organism-specific antibodies, blood-brain barrier integrity, and possible CSF contamination by blood should be considered when assessing CSF results.

†This test was developed and its performance characteristics determined by Focus Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. Performance characteristics refer to the analytical performance of the test.

This test is not approved for New York patient testing.

• Free Kappa and Lambda Light Chains, NEPH (Serum)
• Free Kappa Light Chains, NEPH (Serum)

B2GPI is a phospholipid-binding protein involved in the regulation of the coagulation system. Antibodies recognizing B2GPI are associated with Antiphospholipid Syndrome (APS), characterized by thrombosis, thrombocytopenia, and recurrent fetal loss. Recent studies have shown that autoimmune cardiolipin antibodies actually recognize B2GPI attached to cardiolipin, rather than cardiolipin itself. When compared to the conventional cardiolipin antibody assay, the ELISA measuring B2GPI antibodies in the absence of cardiolipin offers increased specificity for APS.

Test performed at Quest Diagnostics Nichols Institute.

Please see the following technical sheet for more information:
 Beta-2 Glycoprotein 1 (B2GP1) Antibodies and Thrombotic Disease

Beta-2 microglobulin is a protein associated with the Class I antigens of the major histocompatibility antigen system. In lymphoma and leukemia patients, elevated serum and CSF levels of shed beta-2 microglobulin correlate with the clinical involvement of the lymphoid disease. Elevated serum levels are also seen in AIDS patients and during acute renal and cardiac allograft rejection.

This test is approved for New York patient testing.

In lymphoma and leukemia patients, elevated serum and CSF levels of shed beta-2 microglobulin correlate with the clinical involvement of the lymphoid disease.

This test is approved for New York patient testing.

Elevated urine levels are seen in tubulointerstitial disorders after exposure to heavy metals, anti-cancer drugs, aminoglycosides and anti-inflammatory compounds.

This test is approved for New York patient testing.

• Schistosoma IgG Antibody, FMI (CSF)

See individual assay for description.

Panel includes:

• BK Virus DNA Quantitative Real-Time PCR
• JC Virus DNA Quantitative Real-Time PCR

BK virus is a human polyomavirus that, after primary infection, enters latency in the host, most likely in the urogenital tract. Asymptomatic reactivation and intermittent shedding of the virus in urine occur spontaneously in immunocompetent and immunosuppressed persons. Persistent viral replication in recipients of renal allografts can cause progressive dysfunction and eventual loss of the transplanted kidney. The detection of BK Virus is based upon the real time PCR amplification and detection of specific BKVirus genomic sequences from total DNA extracted from the specimen.

This test is approved for New York patient testing.

 Detection and Quantification of BK Virus DNA by PCR

Quantitation of BK virus (BKV) is based upon the real-time PCR amplification and detection of BKV genomic DNA. The quantitative range of this assay is 500 to 39,000,000 BKV DNA copies/mL.

This test is approved for New York patient testing.

 Detection and Quantification of BK Virus DNA by PCR

If BK Virus DNA is detected in the qualitative assay, the specimen will reflex to BK Virus DNA PCR Quantitative PCR (Focus Unit Code 47900) for an additional charge. The quantitative range if reflexed is 200 BKV DNA copies/mL (2.3 log10) to 200 million BKV DNA copies/mL (8.3 log10).

This test is approved for New York patient testing.

BK virus and JC virus are polyomaviruses that commonly infect humans, causing only mild symptoms or none at all. However, in individuals with compromised immune systems, such as transplant recipients and HIV positive patients, BK and/or JC virus infections can cause severe illness. This assay detects the presence of both BK and JC virus DNA. For further monitoring of viral load, please order either unit Code 47900 BK Virus DNA Quantitative PCR, or 41446 JC Virus DNA Quantitative PCR.

This test is not approved for New York patient testing.

Although titers of 1:8 and greater are considered positive, confirmed serological diagnosis of blastomycosis by the CF test requires a four-fold or greater increase in titer between acute and convalescent specimens, and lack of corresponding titers to C. immitis and H. capsulatum. Specificity can only be demonstrated by immunodiffusion procedures. A negative CF test does not rule out the diagnosis of active blastomycosis, as less than 50% of sera from patients with proven blastomycosis are positive by this assay.

This test is approved for New York patient testing.

Detection of intrathecally-produced organism-specific antibodies in CSF indicates central nervous system infection. However, serum levels of organism-specific antibodies, blood-brain barrier integrity, and possible CSF contamination by blood should be considered when assessing CSF results.

This test is approved for New York patient testing.

See individual assay for description.

Panel Includes:

• Blastomyces Antibody, Complement Fixation, Serum
• Blastomyces Antibody, Immunodiffusion, Serum

See individual assay for description.

Panel Includes:

• Blastomyces Antibody, Complement Fixation, CSF
• Blastomyces Antibody, Immunodiffusion, CSF

See individual assays for description.

Panel Includes:

• Blastomyces Antibody, Complement Fixation, Serum
• Blastomyces Antibody, Immunodiffusion, Serum
• Blastomyces dermatitidis IgG Antibody, ELISA^†

A positive result is diagnostic of active or recent blastomycosis and is found in approximately 80% of proven cases of blastomycosis.

This test is approved for New York patient testing.

Detection of intrathecally-produced organism-specific antibodies in CSF indicates central nervous system infection. However, serum levels of organism-specific antibodies, blood-brain barrier integrity, and possible CSF contamination by blood should be considered when assessing CSF results.

This test is available for New York patient testing.

This assay is both highly sensitive and highly specific for B. dermatitidis IgG. Antibodies induced by Aspergillus, Coccidioides, or Histoplasma infection rarely crossreact in this assay. A positive result for a single serum specimen indicates either recent or past B. dermatitidis infection. Recent infection is demonstrated by an increase in B. dermatitidis-specific IgG levels between acute and convalescent sera. Samples exhibiting equivocal or positive results are confirmed by ID (Focus Unit Code 40185) for an additional charge.

†This test was developed and its performance characteristics determined by Focus Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. Performance characteristics refer to the analytical performance of the test.

This test is not approved for New York patient testing.

Conventional laboratory identification methods used to identify Blastomyces dermatitidis include growth on fungal media, growth rate, and colonial and microscopic morphology. Once the organism begins to grow in culture, it may take many days or weeks of additional growth before the characteristic microscopic appearance of sportulation is observed. This test utilizes a chemiluminescent-labeled, single-stranded DNA probe that hybridizes to specific ribosomal RNA sequences that are unique to Blastomyces dermatitidis. Colonies are identified as soon as growth is visible, with no need to wait for sporulation to occur. The sensitivity and specificity of this test both approach 100%.

This test is approved for New York patient testing.

Nasopharyngeal specimens are cultured on selective media containing charcoal and horse blood. Cultures are held for up to 10 days before reporting as negative. Culture is the most sensitive means of detecting Bordetella pertussis/parapertussis in clinical specimens.

This test is approved for New York patient testing.

Smears are stained with fluorescent monoclonal antibodies that will detect the presence of Bordetella pertussis and B. parapertussis in nasopharyngeal specimens. Results of the DFA will be reported as preliminary. Specimens are cultured on selective media containing charcoal and horse blood. Cultures are held for up to 10 days before being reported as negative.

This test is approved for New York patient testing.

Smears are stained with fluorescent monoclonal antibodies that will detect the presence of Bordetella pertussis or B. parapertussis in nasopharyngeal specimens. Culture on appropriate media is more sensitive than DFA, therefore it is recommended that the DFA test for detection of B. pertussis/parapertussis be used in conjunction with culture, not in place of it.

This test is available for New York patient testing.

Despite ongoing global immunization programs, pertussis or ‘whooping cough’ remains a public health concern, as neither acquisition of the disease nor vaccination provides complete or lifelong immunity. This assay is based upon the use of real-time amplification of specific genomic DNA sequences by PCR to differentially detect Bordetella pertussis and Bordetella parapertussis.

This test is not approved for New York patient testing.

Levels of antibodies recognizing pertussis toxin (PT) and filamentous hemagglutinin antigen (FHA) are typically increased following either vaccination or natural exposure to Bordetella pertussis. Increased levels of FHA IgG alone may represent crossreactive antibodies induced by infection with other Bordetella species, Mycoplasma pneumoniae, Chlamydia pneumoniae, or nonencapsulated Haemophilus influenzae.

This test is approved for New York patient testing.

 Evaluation of a Tetraplex Microsphere Assay for Bordetella pertussis Antibodies

 Vaccine Response Testing

Levels of antibodies recognizing pertussis toxin (PT) and filamentous hemagglutinin antigen (FHA) are typically increased following either vaccination or natural exposure to Bordetella pertussis. Detection of IgG antibodies is more sensitive than detection of IgA antibodies, since not all vaccinated or exposed individuals mount a detectable IgA response. Increased levels of FHA antibodies alone may represent crossreactive antibodies induced by infection with other Bordetella species, Mycoplasma pneumoniae, Chlamydia pneumoniae, or nonencapsulated Haemophilus influenzae.

This test is approved for New York patient testing.

 Evaluation of a Tetraplex Microsphere Assay for Bordetella pertussis Antibodies

The isolation of Borrelia burgdorferi in modified Barbour-Stoenner-Kelly medium can be useful in confirming the diagnosis of Lyme Disease in selected patients. Cultures are held for up to 4 weeks.

This test is approved for New York patient testing.

This unit code has been inactivated.

Please see the following unit codes
42200-Tick, 42300-Blood, 42400-CSF and 42500-Urine

The Borrelia burgdorferi Antibody Index is used as an aid in the diagnosis of neuroborreliosis. An increased Borrelia burgdorferi Antibody Index (>1.2), accompanied by a Control Antibody Index of less than 1.0 and an Albumin Ratio of less than 0.0078 is strong evidence for intrathecal synthesis of organism-specific antibody, and thus CNS involvement by B. burgdorferi. Elevation of either the control antibody index, the Albumin Ratio, or both may indicate leakage of antibody across the blood-brain barrier, which may falsely elevate the B. burgdorferi Antibody Index.

This test is available for New York patient testing.

This ELISA detects both IgG and IgM antibodies against the C6 peptide derived from the V1sE protein of Borrelia burgdorferi, the causative agent of Lyme disease. IgM-specific titers usually peak 4 to 6 weeks after onset of infection and may persist in the presence of disease. IgG levels tend to rise above background levels about 2 to 3 weeks after infection, and may remain elevated in cases of prolonged disease. The C6 peptide antibody ELISA exhibits sensitivity and specificity values greater than 95% for Lyme disease. Further, sera from individuals vaccinated with the OspA Lyme disease vaccine do not react in this assay. If automatic reflex to Western blot is desired, please order unit code 44678.

This test is approved for New York patient testing.

This ELISA detects both IgG and IgM antibodies against the C6 peptide derived from the V1sE protein of Borrelia burgdorferi, the causative agent of Lyme disease. The C6 peptide antibody ELISA exhibits sensitivity and specificity values greater than 95% for Lyme disease. Further, sera from individuals vaccinated with the OspA Lyme disease vaccine do not react in this assay. If the ELISA assay is reactive, the specimen will reflex to Borrelia burgdorferi IgG and IgM, Western Blot (Focus Unit Code 2034) for an additional charge.

This test is approved for New York patient testing.

See individual assay for description.

Panel Includes:

• Borrelia burgdorferi C6 Peptide Antibody, ELISA
• Borrelia burgdorferi IgG and IgM Antibody, Western Blot

Specific antibody titers are measured by indirect immunofluorescence assay (IFA). IgG levels tend to rise about 2 to 3 weeks after infection, and may also stay elevated in cases of prolonged disease. Seronegative cases of Lyme disease have been reported and alternate laboratory tests may be necessary to make a diagnosis, e.g., Borrelia burgdorferi PCR. Crossreactivity is observed with other Borrelia and Treponema species.

This test is not approved for New York patient testing.

Detection of intrathecally-produced organism-specific antibodies in CSF indicates central nervous system infection. However, serum levels of organism-specific antibodies, blood-brain barrier integrity, and possible CSF contamination by blood should be considered when assessing CSF results.

This test is not approved for New York patient testing.

The presence of IgG antibody to five or more of the following ten Borrelia burgdorferi proteins is considered positive for Lyme disease: 18, 23, 28, 30, 39, 41, 45, 58, 66 and 93.

This test is approved for New York patient testing.

No interpretive criteria for Lyme Western blot have been established for CSF or other fluids. The presence of Borrelia burgdorferi reactive antibodies in fluids may represent either compartmental antibody production or transudation of plasma antibody. The Western blot test will confirm the presence of Borrelia burgdorferi specific antibodies detected by serologic screening methods (ELISA, IFA).

This test is not approved for New York patient testing.

No interpretive criteria for Borrelia burgdorferi Western blot have been established for CSF or other fluids. The presence of B. burgdorferi reactive antibodies in fluids may represent either compartmental antibody production or transudation of plasma antibody. The Western blot test will confirm the presence of Borrelia burgdorferi specific antibodies detected by serologic screening methods (ELISA, IFA).

This test is not approved for New York patient testing.

Specific IgG and IgM are measured by IFA. IgM-specific titers usually peak 4 to 10 weeks after onset of infection and may persist for up to a year in the presence of disease. IgG levels tend to rise above background levels about 2 to 3 weeks after infection, and may also stay elevated in cases of prolonged disease. Detectable IgG levels may be delayed for up to 8 months. IgG titers of 1:16-1:32 are considered equivocal. Seronegative cases of Lyme disease have been reported and alternate laboratory tests may be necessary to make a diagnosis (e.g., PCR or culture). Crossreactivity is shown with other Borrelia and Treponema species.

This test is not approved for New York patient testing.

Detection of intrathecally-produced organism-specific antibodies in CSF indicates central nervous system infection. However, serum levels of organism-specific antibodies, blood-brain barrier integrity, and possible CSF contamination by blood should be considered when assessing CSF results.

This test is not approved for New York patient testing.

The Western blot detection of antibody to Borrelia burgdorferi antigens is intended for use as an ancillary test for serologic diagnosis of Lyme disease. It is especially useful for the evaluation of specimens yielding questionable results by IFA and/or ELISA. The early IgM and IgG response to B. burgdorferi is usually limited to the 41 kD flagellar protein. With time IgG antibodies are detected against numerous antigenic determinants of the spirochete. The criteria for a positive IgG Western blot requires the presence of antibody to at least five of ten specific Borrelia proteins; criteria for positive IgM requires the presence of antibody to two of three specific proteins.

No interpretive criteria for Borrelia burgdorferi Western blot have been established for CSF or other fluids. The presence of B. burgdorferi reactive antibodies in fluids may represent either compartmental antibody production or transudation of plasma antibody. The Western blot test will confirm the presence of B. burgdorferi specific antibodies detected by serologic screening methods (ELISA, IFA).

This test is not approved for New York patient testing.

No interpretive criteria for Borrelia burgdorferi Western blot have been established for CSF or other fluids. The presence of B. burgdorferi reactive antibodies in fluids may represent either compartmental antibody production or transudation of plasma antibody. The Western blot test will confirm the presence of Borrelia burgdorferi specific antibodies detected by serologic screening methods (ELISA, IFA).

This test is not approved for New York patient testing.

Specific antibody titers are measured by indirect immunofluoresence assay (IFA). IgM-specific titers usually peak 4 to 6 weeks after onset of infection and may persist in the presence of severe disease. IgG levels tend to rise about 2 to 3 weeks after infection, and may also stay elevated in cases of prolonged disease.

This test is not approved for New York patient testing.

Detection of intrathecally-produced organism-specific antibodies in CSF indicates central nervous system infection. However, serum levels of organism-specific antibodies, blood-brain barrier integrity, and possible CSF contamination by blood should be considered when assessing CSF results.

This test is not approved for New York patient testing.

CDC criteria for a positive Lyme disease IgM Western blot require the presence of antibody to at least 2 of 3 specific borrelial proteins (23 (ospC), 39, 41). Although considered a negative result, the presence of one IgM band may occur with recent exposure to Borrelia burgdorferi and may warrant further serologic testing if clinically indicated. Reactivity to p41 may be observed in sera from normal individuals, as well as patients with a variety of other diseases, including sera containing anti-nuclear antibody (ANA).

This test is approved for New York patient testing.

No interpretive criteria for B. burgdorferi Western blot have been established for CSF or other fluids. The presence of Borrelia burgdorferi reactive antibodies in fluids may represent either compartmental antibody production or transudation of plasma antibody. The Western blot test will confirm the presence of Borrelia burgdorferi specific antibodies detected by serologic screening methods (ELISA, IFA).

This test is not approved for New York patient testing.

No interpretive criteria for Borrelia burgdorferi Western blot have been established for CSF or other fluids. The presence of B. burgdorferi reactive antibodies in fluids may represent either compartmental antibody production or transudation of plasma antibody. The Western blot test will confirm the presence of Borrelia burgdorferi specific antibodies detected by serologic screening methods (ELISA, IFA).

This test is not approved for New York patient testing.

Borrelia hermsii is a cause of American tick-borne relapsing fever in the Western United States. Cultures are held up to 4 weeks.

This test is approved for New York patient testing.

Single IgG titers of 1:64 and greater against Borrelia hermsii are considered presumptive evidence of infection by Borrelia. A fourfold or greater change in titer between acute and convalescent sera provides evidence or recent or current infection. Acute sera generally show specific IgM titers >=1:16 while patients with manifestations of later stages of disease display elevated IgG titers only. Crossreactivity is shown with other Borrelia species and Treponema; therefore, positive specimens should be assayed in parallel against these antigens when possible to identify the specific species causing infection.

This test is not approved for New York patient testing.

Single IgG titers of 1:64 and greater against Borrelia hermsii are considered presumptive evidence of infection by Borrelia. A fourfold or greater change in titer between acute and convalescent sera provides evidence or recent or current infection. Crossreactivity is shown with other Borrelia species and Treponema; therefore, positive specimens should be assayed in parallel against these antigens when possible to identify the specific species causing infection.

This test is not approved for New York patient testing.

Acute sera generally show specific IgM titers >=1:16 while patients with manifestations of later stages of disease display elevated IgG titers only. Crossreactivity is shown with other Borrelia species and Treponema; therefore, positive specimens should be assayed in parallel against these antigens when possible to identify the specific species causing infection.

This test is not approved for New York patient testing.

This unit code has been inactivated.

Please see unit code 40010.

Approximately 5% of brucellosis cases are characterized by central nervous system involvement, and detection of Brucella-specific antibodies in CSF may aid in their diagnosis. However, interpretation of results may be complicated by many factors, including low antibody levels in CSF, passive transfer of antibodies from blood, and serum contamination of CSF in bloody taps. For appropriate interpretation, CSF antibody results should be considered within the context of serum antibody results.

This test is not approved for New York patient testing.

This unit code has been inactivated.

Please see unit code 40005.

Acute brucellosis is characterized by the appearance of Brucella-specific IgM within the first week of infection, followed by the appearance of Brucella-specific IgG after the second week. Levels of both IgM and IgG decline slowly over several months in conjunction with recovery. Persistence of high IgG levels with declining or absent IgM suggests chronic infection or relapse.

This test is approved for New York patient testing.

IgG titers >=1:128 for a single serum are indicative of exposure to Burkholderia pseudomallei, while a four-fold or greater increase in IgG titer between acute and convalescent sera confirms infection.

This test is available for New York patient testing.

IgG titers >=1:128 for a single serum are indicative of exposure to Burkholderia pseudomallei, while a four-fold or greater increase in IgG titer between acute and convalescent sera confirms infection.

This test is available for New York patient testing.

An IgM titer of 1:40 or greater suggests recent or current infection.

This test is available for New York patient testing.

This assay provides a titer for Brucella antibodies and may be used to confirm positive results obtained using an ELISA method. The most reliable serologic indicator of brucellosis is a four-fold increase in antibody titer when testing acute and convalescent sera in parallel. In the absence of paired sera, a single specimen titer of 1:80 or greater is consistent with brucellosis in a patient with a compatible clinical history.

This test is approved for New York patient testing.