Infectious Disease
Lyme Disease
NICE NG95 — erythema migrans = clinical diagnosis; targeted serology for non-EM features; doxycycline first-line.
Source: NICE NG95 (2018)
Step 1 of ~4
info
Recognise
History: tick exposure (UK endemic — moorland, woodland, especially Highlands, Lake District, North Yorkshire, New Forest, Surrey).
Features by stage:
• Early localised (3–30 days): erythema migrans (≥5 cm, expanding bullseye lesion) — present in 70%, diagnostic.
• Early disseminated: multiple EM, facial nerve palsy / cranial neuropathy, lymphocytic meningitis, atrioventricular block, arthralgia.
• Late (months-years): Lyme arthritis, late neuroborreliosis, acrodermatitis chronica atrophicans (Europe-typical).
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Ethambutol · Antitubercular — First-Line TB (RIPE Regimen, 'E')
- Pyrazinamide · Antitubercular — First-Line TB (RIPE Regimen, 'P')
- Ethinylestradiol with levonorgestrel · Combined oral contraceptive (2nd-generation progestogen — first-line)
- Paracetamol (Paediatric) · Analgesic / Antipyretic — First-Line Pain and Fever in Children
- Midazolam (Paediatric) · Benzodiazepine — Status Epilepticus (First-Line) / Procedural Sedation
- Inclisiran · PCSK9-targeted siRNA
Pathways
- Infective Endocarditis · ESC 2023 Infective Endocarditis Guidelines; NICE NG41
- Eczema Herpeticum · BAD; NICE CKS
- Suspected Bacterial Meningitis (Adult) · NICE NG240 (2024); NICE NG143 (paeds)
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021
- Returning Traveller — Fever · NaTHNaC; PHE; ESCMID 2018
- Malaria — Diagnosis & Management · PHE 2016; WHO 2023
Decision support only. Always apply local guidelines and clinical judgement.