This page contains a summary of information and links to the NHS webpage on Lyme disease, NICE Lyme disease guideline and RCGP Lyme Disease Toolkit (page last updated July 2025).
The purpose of bringing these resources together onto one webpage is to provide health professionals and patients with an at-a-glance summary of the latest information to aid early diagnosis and treatment of Lyme disease.
RCGP Lyme Disease Toolkit
These three NUBs – New and Useful Bits – provide information at your fingertips, summarising the key aspects of diagnosing Lyme disease, managing Lyme disease, and ongoing management and prevention. Each contains links to further information and resources, making it easy to access everything you need. To view the Toolkit on the RCGP website visit – https://elearning.rcgp.org.uk/course/view.php?id=1157
Lyme Disease Rash Images
The images below have been copied from the NICE Lyme disease guideline and can be found here – https://www.nice.org.uk/guidance/ng95/resources/lyme-disease-rash-images-pdf-4792273597 
Lyme Disease Testing
The flow chart below has been copied from the NICE Lyme disease guideline and can be found here – https://www.nice.org.uk/guidance/ng95/resources/visual-summary-pdf-4792272301.
Lyme disease: sample testing advice Information to assist with the laboratory diagnosis of Lyme disease and requirements for sample submission. https://www.gov.uk/guidance/lyme-disease-sample-testing-advice
BMJ Visual summary of antibiotic choices
NICE Lyme Disease Guideline Antibiotic Choices: Offer antibiotic treatment according to symptoms (see tables 1&2) https://www.nice.org.uk/guidance/ng95/chapter/recommendations#information-for-people-with-lyme-disease
NICE Lyme Disease Guideline
https://www.nice.org.uk/guidance/ng95
Key statements:
1.2.11 Diagnose and treat Lyme disease without laboratory testing in people with erythema migrans.
1.2.12 Use a combination of clinical presentation and laboratory testing to guide diagnosis and treatment in people without erythema migrans. Do not rule out diagnosis if tests are negative but there is high clinical suspicion of Lyme disease.
1.2.13 If there is a clinical suspicion of Lyme disease in people without erythema migrans:
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offer an ELISA test for Lyme disease and
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consider starting treatment while waiting for the results if there is a high clinical suspicion
1.2.18 If Lyme disease is still suspected in people with a negative ELISA who have had symptoms for 12 weeks or more, perform an immunoblot
1.2.19 Diagnose Lyme disease in people with symptoms of Lyme disease and a positive immunoblot test.
1.2.3 Consider the possibility of Lyme disease in people presenting with several of the following symptoms , because Lyme disease is a possible but uncommon cause of :
fever and sweats, swollen glands, malaise, fatigue, neck pain or stiffness, migratory joint or muscle aches and pain, cognitive impairment, such as memory problems and difficulty concentrating (sometimes described as ‘brain fog’), headache, paraesthesia.
1.2.4 Consider the possibility of Lyme disease in people presenting with symptoms and signs relating to 1 or more organ systems (focal symptoms) because Lyme disease is a possible but uncommon cause of
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neurological symptoms, such as facial palsy or other unexplained cranial nerve palsies, meningitis, mononeuritis multiplex or other unexplained radiculopathy; or rarely encephalitis, neuropsychiatric presentations or unexplained white matter changes on brain imaging
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inflammatory arthritis affecting 1 or more joints that may be fluctuating and migratory
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cardiac problems, such as heart block or pericarditis
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eye symptoms, such as uveitis or keratitis
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skin rashes such as acrodermatitis chronica atrophicans or lymphocytoma.
The NICE guideline on Lyme disease acknowledges a limited evidence base and highlights the need for further research to improve diagnosis and treatment. Read the section of the NICE guideline that refers to the limited evidence base here.