From the Guidelines
A positive Lyme IgG antibody test with a negative IgM antibody test typically indicates past infection rather than active Lyme disease requiring treatment. This pattern suggests your immune system encountered Borrelia burgdorferi (the Lyme bacteria) in the past and developed long-term antibodies (IgG), but is not currently fighting an active infection (which would show positive IgM) 1.
Key Considerations
- Treatment is generally not recommended in this situation unless you have persistent symptoms clearly attributable to Lyme disease.
- If you do have ongoing symptoms like joint pain, fatigue, or neurological issues that could be related to Lyme, consult with an infectious disease specialist who might consider a 2-4 week course of doxycycline (typically 100mg twice daily) 1.
- However, it's essential to rule out other potential causes of your symptoms, as IgG antibodies can remain positive for years or even decades after the infection has been cleared, and treating based solely on antibody results without clinical symptoms is not standard practice 1.
- The persistence of IgG antibodies does not necessarily indicate ongoing infection requiring antibiotic therapy.
Treatment Options
- For patients with persistent or recurring nonspecific symptoms, additional antibiotic therapy is not recommended unless there is objective evidence of reinfection or treatment failure 1.
- In patients with Lyme arthritis, a 2-4 week course of oral antibiotics or a 2-4 week course of IV ceftriaxone may be considered 1.
- Symptomatic therapy, such as nonsteroidal anti-inflammatory agents or intra-articular injections of corticosteroids, may be recommended for patients with antibiotic-refractory Lyme arthritis 1.
From the Research
Lyme Disease Diagnosis and Treatment
- Lyme disease is a tick-borne illness that can be diagnosed through clinical presentation and laboratory tests, including antibody tests such as IgG and IgM 2.
- A positive IgG antibody test, like in the case of a Lyme IgGAb positive result, indicates a past or current infection, while a negative IgM antibody test suggests that the infection is not in the early stages 2.
Treatment Options
- The treatment of Lyme disease typically involves antibiotics, with doxycycline and amoxicillin being common first-line options 2, 3.
- For more severe cases, intravenous ceftriaxone or penicillin G may be used 2, 4.
- Other antibiotics, such as cefuroxime axetil and azithromycin, may also be effective in treating Lyme disease 3, 5.
Interpretation of Test Results
- A positive Lyme IgGAb result, combined with a negative IgM result, may indicate a current or past infection that requires treatment 2.
- However, the interpretation of these results should be done in conjunction with clinical symptoms and other diagnostic criteria 2, 3.
Need for Treatment
- Given the positive Lyme IgGAb result and the presence of active inflammation, treatment with antibiotics may be necessary to manage the infection and prevent further complications 2, 3, 4.
- The choice of antibiotic and treatment duration will depend on the severity of the infection, the patient's overall health, and other factors, and should be determined by a healthcare professional 2, 3, 5, 4, 6.