NICE publish quality standard on the diagnosis and management of Lyme disease
For Lyme disease
- Statement 1 People presenting with erythema migrans (a large, raised, red spot that appears at the site of the bite, usually on the thigh, buttock, or trunk or in the armpit) are diagnosed and treated for Lyme disease based on clinical assessment, without laboratory testing.
- Statement 2 People with suspected Lyme disease without erythema migrans who have a negative enzyme-linked immunosorbent assay (ELISA) test carried out within 4 weeks of their symptoms starting have the test repeated 4 to 6 weeks later if Lyme disease is still suspected.
- Statement 3 People with Lyme disease have initial antibiotic treatment, with the antibiotic, dosage and duration determined by their symptoms.
- Statement 4 Local authorities organise health promotion activities in conjunction with organisations in their area to raise public awareness about how to prevent Lyme disease.
- a high temperature, or feeling hot and shivery
- muscle and joint pain
- tiredness and loss of energy
© NICE 
NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/publication.
The information provided by NICE was accurate at the time this article was issued.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions (side effects) after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals or patients are asked to report any suspected adverse reactions via the Yellow Card Scheme at yellowcard.mhra.gov.uk or search for MHRA Yellow Card in the Google Play or Apple App Store.
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