Posted 7/11/2015 5:55 PM (GMT 0)
Also — a comment about spinal taps:
I'm assuming your ID MD suggested the spinal tap?
Lyme don't live in spinal fluid in any great numbers, so it's not a test to rely on to diagnose (or to rule out) Lyme.
Lyme specialists don't generally look to spinal fluid to diagnose or to rule out Lyme. From the 2008 ILADS guidelines, posted at ILADS.org:
"Spinal taps are not routinely recommended, as a negative tap does not rule out Lyme. Antibodies to Bb are mostly found in Lyme meningitis, and are rarely seen in non-meningitic CNS infection, including advanced
encephalopathy.
Even in meningitis, antibodies are detected in the CSF in less than 13% of patients with late disease!
Therefore, spinal taps are only performed on patients with pronounced neurological manifestations in whom the diagnosis is uncertain, if they are seronegative, or are still significantly symptomatic after completion of treatment. When done, the goal is to rule out other conditions, and to determine if Bb (and Bartonella) antigens or nucleic acids are present. It is especially important to look for elevated protein and white cells, which would dictate the need for more aggressive therapy, as well as the opening pressure, which can be elevated and add to headaches, especially in children."
-p