Diagnosis and management of patients with Lyme disease: NICE guideline

摘要

The National Institute for Health and Care Excellence (NICE) has published a new guideline on diagnosis and management of Lyme disease.1 The guideline aims to increase awareness of Lyme disease and ensure that patients get the correct treatment at an early stage.Lyme disease is a bacterial infection transmitted by the bite of an infected tick. The bacterium Borrelia burgdorferi is a spirochete with many similarities to the syphilis organism. Ticks inject a local anaesthetic to the site of the bite and often attach themselves at the hairline or in the axillae or groin areas, so they can be easy to miss.Ticks are found in grassy and woodland areas, including urban gardens and parks. Not all ticks carry Lyme disease, but infected ticks have been identified in urban and peri-urban areas.2 There is a perception that Lyme disease only occurs in certain areas and, although some areas have a higher prevalence, cases are reported throughout the UK. People in certain occupations, for example, farm workers, are at higher risk but anyone who spends time outside is at risk. Worldwide, higher prevalence is noted in Central, Eastern, and Northern Europe, the US and Canada, and parts of Asia. A good occupational, travel, and lifestyle history is important when assessing patients.Lyme disease is a multisystem illness and can present with a variety of focal and non-focal symptoms and …