Lyme disease
Lyme disease is a multisystem infection caused by Borrelia species and transmitted by Ixodes ticks; diagnose erythema migrans clinically, use accredited serology for presentations without the rash, and escalate focal neurological, cardiac, ocular, joint, pregnancy and paediatric disease through the current NICE pathway.
Definition
Lyme disease, or Lyme borreliosis, is infection with bacteria from the Borrelia burgdorferi sensu lato complex, transmitted by infected Ixodes ticks. It can cause early skin disease and later neurological, cardiac, ocular, joint and other multisystem manifestations.
First principles
The infection follows an Ixodes tick bite
Borrelia burgdorferi sensu lato bacteria are transmitted by infected Ixodes ticks found in grassy and wooded areas, including urban parks and gardens. Most tick bites do not transmit Lyme disease, and prompt, correct tick removal reduces risk. A tick bite may not be remembered, so exposure history should include outdoor activity and travel rather than relying on a recalled bite.
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