--- title: Case Study - Is lyme disease under-diagnosed in the UK? description: Case Study - Is lyme disease under-diagnosed in the UK? image: https://blog.lantum.com/hubfs/Blog_Media/questionmark-grass4-533x510.jpg --- [![Lantum](https://blog.lantum.com/hubfs/Lantum%20March2018/Images/logo-header.svg)](https://us.lantum.com) for Locums - [Locums](https://lantum.com/) - [Practices](https://lantum.com/p/practices/) - [Hubs](https://lantum.com/p/hubs/) - [Federations](https://lantum.com/p/nhs-federation/) [Advice Guide](https://blog.lantum.com/tag/advice-guide), [Primary Care](https://blog.lantum.com/tag/primary-care), [RCGP](https://blog.lantum.com/tag/rcgp), [diagnosis](https://blog.lantum.com/tag/diagnosis), [GP locum](https://blog.lantum.com/tag/gp-locum), [NHS](https://blog.lantum.com/tag/nhs), [Case Study](https://blog.lantum.com/tag/case-study), [Clinical](https://blog.lantum.com/tag/clinical), [Continuous Professional Development](https://blog.lantum.com/tag/continuous-professional-development) 14 Oct 2014 [![](https://blog.lantum.com/hubfs/Blog_Media/questionmark-grass4-533x510.jpg)](https://blog.lantum.com/p/blog/clinical/case-study-is-lyme-disease-under-diagnosed-in-the-uk) # Case Study - Is lyme disease under-diagnosed in the UK? 18 Comments - [Tweet](https://twitter.com/share) Being a London GP, I was surprised when a patient presented with a sort-of ‘erythema migrans’ type rash a week after attending a music festival nearby. He could not remember being bitten and described a prodromal flu-like illness. I was faced with a few options – if this was cellulitis then I should treat with flucloxacillin and penicillin; if it was lyme disease should I request serology to confirm and then treat with doxycycline? Or should I prescribe doxycycline 100mg BD for 14 days immediately (the correct option!)? It occurred to me that GPs may falsely conclude that a negative *Borrelia *serology excludes a diagnosis of Lyme disease and that Lyme disease in the UK is significantly under-diagnosed. [Lyme Disease Action](http://bit.ly/1jnns3E) and the RCGP have collaborated to raise the awareness of this tick-transmitted condition in efforts to improve primary care detection and early management which confers a better prognosis. **Here are some key points about Lyme disease in the UK:** - Lyme borreliosis occurs **throughout **UK, not just woodland areas. - There is no test of disease activity and no test of cure so diagnosis should be clinical - The main season for the disease is from March to October, though disseminated disease may present throughout the year - 1 in 3 people do not recall a tick bite - If you are unsure whether there is erythema migrans or cellulitis **treat with doxycycline** - If there is a tick bite and typical early symptoms, treat without waiting for serology results - Serology within six weeks of infection has a high chance of being negative - Early antibiotics may abrogate the immune response and lead to negative serology - If disseminated disease occurs it may lead to cardiac, ophthalmological, rheumatological and neurological complications To learn more about Lyme disease and how to diagnose it in primary care visit the [RCGP’s online learning environment.](http://bit.ly/1wxRO8A) Dr. Ishani Patel MBBS BSc MRCGP DCH DRCOG General Practitioner E-learning CPD Fellow, RCGP Associate GP, Transforming Cancer Services Team, London Advisory Committee on Cervical Screening (ACCS), Public Health England   [![facebook_icon_30x30](https://blog.lantum.com/hs-fs/hubfs/Imported_Blog_Media/facebook_icon_30x305-4.gif?width=30&height=30&name=facebook_icon_30x305-4.gif)](https://blog.lantum.com/hubfs/Imported_Blog_Media/facebook_icon_30x305-4.gif)www.facebook.com/networklocum [![twitter icon](https://blog.lantum.com/hs-fs/hubfs/Imported_Blog_Media/twitter-icon6-8.jpg?width=33&height=27&name=twitter-icon6-8.jpg)](https://blog.lantum.com/hubfs/Imported_Blog_Media/twitter-icon6-8.jpg)[@wearelantum](http://bit.ly/1sKB3sa) ### Author [Lantum](https://blog.lantum.com/author/lantum) ### Subscribe to the newsletter ### Subscribe to the newsletter ### About Lantum Lantum is a workforce platform that uses technology to simplify all aspects of healthcare staffing. 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