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Lyme disease: time for a new approach?

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h6520 (Published 03 December 2015) Cite this as: BMJ 2015;351:h6520

Rapid Response:

Lyme disease: time for a new approach?

Professor Liesbeth Borgermans et al are right in recommending further research to elucidate, firstly, the debatable clinical manifestations associated with Lyme disease and tick bites and, secondly, the imprecise nature of microbial investigations. But diagnostic microbiology laboratories not infrequently receive queries from General Practitioner colleagues about whether antimicrobials should be administered or not in cases of tick bites without the typical rash of Lyme disease or with no rash at all. This is either initiated by the patient or the doctor who is worried about the risk of Lyme disease. Further research in the area of prophylactic or pre-emptive treatment would be very helpful. As for the laboratory investigations, most microbiology laboratories cannot perform the test locally and therefore have to send it to the reference laboratory, which may take weeks until the result comes back. This is unhelpful but to explore the possibility of doing this test accurately and reliably locally significantly improves the identification and treatment of this condition.

Department of Medical Microbiology and infection Prevention and Control.
The Rotherham NHS Foundation Trust.

Competing interests: No competing interests

13 December 2015
Walid Al-Wali
Consultant Medical Microbiologist and Director for Infection Prevention and Control
Christopher Hughes, Clinical Scientist and Laboratory Manager
The Rotherham NHS Foundation Trust
Moorgate Road, Oakwood, Rotherham S60 2UD