In most places, serological investigations are used for the investigation of suspected Lyme disease. Blood or another fluid (such as CSF) is subject to two-stage testing. An ELISA is performed first and specificity is then enhanced by a subsequent Western blot.
Borrelia are difficult to culture but in specialist labs facilities may be available.
PCR tests are also used.
Testing in Scotland is via the Scottish Lyme Disease and Tick-borne infections Reference Laboratory in Raigmore Hospital.