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Test ID BMIYC Borrelia miyamotoi Detection PCR, Spinal Fluid

Useful For

Aids in the diagnosis of Borrelia miyamotoi infection in conjunction with clinical findings

 

This test is not useful for detecting the Borrelia species that cause Lyme disease.

Highlights

This test is intended as an aid in the diagnosis of Borrelia miyamotoi infection in conjunction with clinical findings.

 

The preferred method for detecting B miyamotoi is polymerase chain reaction.

Method Name

Real-Time Polymerase Chain Reaction (PCR)

Reporting Name

Borrelia miyamotoi Detection PCR, C

Specimen Type

CSF


Ordering Guidance


This assay does not detect the Borrelia species that cause Lyme disease.



Specimen Required


Container/Tube: Sterile vial

Specimen Volume: 1 mL

Collection Instructions: Submit aliquot from collection vial 2.


Specimen Minimum Volume

0.3 mL

Specimen Stability Information

Specimen Type Temperature Time
CSF Refrigerated (preferred) 7 days
  Frozen  7 days

Reject Due To

  All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Clinical Information

Borrelia miyamotoi is a spirochetal bacterium. It is a member of the tick-borne relapsing fever borreliae and is more distantly related to the Borrelia species that cause Lyme disease. This organism causes a febrile illness with body and joint pain, fatigue, and, rarely, rash, and has been detected in Ixodes scapularis and Ixodes pacificus ticks. These ticks are also the vectors for Lyme disease, anaplasmosis, and babesiosis.

 

The preferred method for detecting B miyamotoi is real-time polymerase chain reaction. Less commonly, B miyamotoi spirochetes can be detected in cerebrospinal fluid preparations in patients with invasive neurologic disease. This assay does not detect the Borrelia species that cause Lyme disease.

Reference Values

Negative

Interpretation

A positive result indicates the presence of Borrelia 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. Less commonly, this test may also detect the nucleic acid of other relapsing fever borreliae; when detected, the report indicates the presence of relapsing fever Borrelia species, not B miyamotoi.

Cautions

Inadequate specimen collection or improper storage may invalidate test results.

 

Borrelia miyamotoi DNA may be detectable for an unknown period of time after adequate treatment.

Clinical Reference

1. Centers for Disease Control and Prevention. About Hard Tick Relapsing Fever. CDC; 2024. Accessed December 30, 2025. Available at www.cdc.gov/relapsing-fever/about/about-htrf.html

2. Hoornstra D, Azagi T, van Eck JA, et al. Prevalence and clinical manifestation of Borrelia miyamotoi in Ixodes ticks and humans in the northern hemisphere: a systematic review and meta-analysis. Lancet Microbe. 2022;3(10):e772-e786. doi:10.1016/S2666-5247(22)00157-4

3. Miller JM, Binnicker MJ, Campbell S, et al. Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2024 Update by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM). Clin Infect Dis. Published online March 5, 2024. doi:10.1093/cid/ciae104

4. Kubiak JM, Klevay M, Hilt EE, Ferrieri P. Acute meningoencephalitis associated with Borrelia miyamotoi, Minnesota, USA. Emerg Infect Dis. 2024;30(7):1472-1474. doi:10.3201/eid3007.231611

5. Rodino KG, Pritt BS. When to think about other borreliae:: Hard tick relapsing fever (Borrelia miyamotoi), Borrelia mayonii, and beyond. Infect Dis Clin North Am. 2022;36(3):689-701. doi:10.1016/j.idc.2022.04.002

Method Description

The assay is performed on the Roche LightCycler (LC) 480 instrument, following DNA extraction on the Roche MagNA Pure. The LC 480 instrument amplifies and monitors the development of target nucleic acid (amplicon) after each polymerase chain reaction (PCR) cycle.

 

The DNA target for this PCR assay is a gene encoding the glycerophosphodiester phosphodiesterase (glpQ) gene specific to Borrelia species in the relapsing fever group. This gene is not found in Borrelia species that cause Lyme disease.

 

The specific base pair DNA target sequence is amplified by PCR. The detection of amplicon is based on fluorescence resonance energy transfer (FRET), which utilizes 1 hybridization probe with a donor fluorophore, fluorescein, at the 3' end, and a second hybridization probe with an acceptor fluorophore, LC-Red 640, at the 5' end. When the target amplicon is present, the LC-Red 640 emits a measurable and quantifiable light signal at a specific wavelength. Presence of the specific organism nucleic acid is confirmed by performing a melting temperature analysis of the amplicon; the presence or absence of a melting peak in the appropriate temperature range is used to determine if a specimen is positive or negative.(Unpublished Mayo method)

Day(s) Performed

Monday through Sunday

Report Available

1 to 4 days

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

87478

NY State Approved

Yes

Forms

If not ordering electronically, complete, print, and send Microbiology Test Request (T244) with the specimen.

Testing Algorithm

For more information see Acute Tick-Borne Disease Testing Algorithm