What specimens should be obtained to establish a diagnosis of Lyme borreliosis?

To establish a diagnosis of Lyme borreliosis, the most relevant specimens are blood, cerebrospinal fluid (CSF), and skin biopsy. Blood samples are crucial for serological testing, which detects antibodies against Borrelia burgdorferi, the causative agent of Lyme disease. The presence of these antibodies can indicate an active or past infection.

CSF may be analyzed in cases where neurological symptoms are present, as Lyme disease can lead to neuroborreliosis, which affects the central nervous system. Examining CSF can help confirm the diagnosis in these instances by revealing specific immune response changes.

A skin biopsy can also provide valuable information, especially in the early stages of Lyme disease when erythema migrans (the characteristic skin lesion) is present. The biopsy can be examined histologically or cultured to isolate the bacteria, although culture results are often difficult to obtain.

Other specimen types listed, such as those from lymph nodes, hair, fingernails, saliva, and sputum, are not typically associated with the diagnosis of Lyme borreliosis and do not provide the necessary information for a definitive diagnosis of this specific disease.