Lyme disease: diagnosis and management

Area of Science:

• Infectious Diseases
• Neurology
• Public Health

Background:

• Lyme disease (borreliosis) is a bacterial infection transmitted by Ixodes ticks, caused by Borrelia burgdoferi.
• Increasing case numbers and widening distribution in the UK, particularly in woodland areas with temperate climates.
• The condition typically presents in mid to late summer and is a multisystem disease.

Purpose of the Study:

• To review the clinical spectrum of neuroborreliosis, a common manifestation of Lyme disease.
• To highlight key aspects of the 2018 National Institute for Health and Care Excellence (NICE) guidelines for Lyme disease diagnosis and management.
• To provide illustrative case examples of neuroborreliosis.

Main Methods:

• Review of clinical presentations and manifestations of Lyme disease, with a focus on neurological involvement.
• Analysis of the 2018 NICE guidelines for diagnosis and management.
• Case study review of patients with neuroborreliosis.

Main Results:

• The nervous system is the second most commonly affected system in Lyme disease after the skin.
• Other systemic manifestations like carditis, keratitis, uveitis, and inflammatory arthritis are rare in European Lyme disease.
• Updated guidelines provide a framework for diagnosis and management.

Conclusions:

• Neuroborreliosis represents a significant clinical challenge in Lyme disease management.
• Adherence to updated diagnostic and management guidelines is crucial.
• Further understanding of the clinical spectrum aids in timely diagnosis and treatment.