IMPORTANT: Currently, we are suspending new patients consultations. Due to a high level of community demand, there are long waits for routine and follow up appointments in our clinic. We will re-open new patients consultations and re-start taking new queries in Summer 2019. Alternatively, we will give you the update here as soon as this option becomes available again. We hope to have your kind understanding.

Call: +353 (0)76 680 3364

Our Treatments


Following consultation and testing, an individualised treatment regime is designed for each patient. Usually these consist of an oral antibiotic or combination of antibiotics. The current antibiotics are well absorbed and have good bioavailability and IV treatment is not required as a rule, although those who fail to respond to oral treatments may be recommended for such regimes.

Treatments last for one month or longer. In addition, advice about lifestyle and other supplemental therapies are given.

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Lyme Disease:

Lyme disease is a multisystem illness caused by infection with the spirochete Borrelia burgdorferi and the body's immune response to the infection. The disease is transmitted to humans via tick bites, from infected ticks of the genus Ixodes.

Signs and symptoms

Signs and symptoms of Lyme disease vary by disease stage. Physical findings in patients with early disease are as follows:

  • Erythema migrans (EM) - Rash
  • Fever
  • Myalgias
  • Malaise
  • Arthralgia
  • Headache
  • Tender local adenopathy (local, not diffuse)

Physical findings in patients with early disseminated disease are as follows:

  • EM (single or multiple lesions)
  • Headache
  • Fever
  • Tender adenopathy (regional or generalized)
  • Conjunctivitis (uncommon, never prominent)
  • Carditis (usually manifests as heart block)
  • Meningismus as a sign of aseptic meningitis
  • Cranioneuropathy, especially cranial nerve VII and Bell palsy (peripheral seventh nerve palsy with decreased unilateral function, including the forehead)

In patients with late disease, the typical physical finding is arthritis. Arthritis is located mostly in large joints, especially the knee. Warmth, swelling from effusion, and limited range of motion help distinguish arthritis from simple arthralgia.

See Clinical Presentation for more detail.


In endemic areas, patients with probable erythema migrans and a recent source of tick exposure should be started on treatment without blood tests. For serologic testing, the CDC recommends a two-tier testing procedure, as follows :

  • Step 1: EIA or ELISA - Total Lyme titer or IgG and IgM titers
  • Step 2: Western blot testing

Western blot testing is performed only if step 1 test results are positive or equivocal. If signs and symptoms have been present for 30 days or less, both IgM and IgG Western blot testing are performed; if signs and symptoms have been present for more than 30 days, only IgG Western blot testing is performed.

Since there is no reason to perform a titer without a confirmatory test if positive, Lyme titers should always be ordered with a reflex confirmatory test. In most cases, this should be a Western blot. Most commercial laboratories will perform both IgG and IgM Western blots. If the patient has been in Europe, where different strains of Borrelia are more common, a C6 peptide ELISA is a more accurate confirmatory test than the Western blots, which have been developed to B burgdorferi, which is the strain found in the United States. The C6 peptide is less expensive than the Western blots and is as sensitive and specific for B burgdorferi; it is a reasonable alternative for the Western blots, but has not replaced it as the usual confirmatory test in the United States


Ticks can carry more than one disease at a time, so it's possible to contract multiple infections from just one bite.

Like Lyme, many tick-borne infections have flu-like symptoms ­ such as fever and headache ­ which makes diagnosis difficult.

Lyme treatment is complicated by co-infections. Patients with co-infections often don't respond well to the usual treatments, and it takes an experienced doctor to properly identify and treat each tick-borne infection. Co-infection generally results in more severe illness, more symptoms, and a longer recovery

As part of testing for the infections associated with lyme disease, in addition to Lyme serology, a battery of tests is performed to other coinfections and other bacterial and viral pathogens that have been associated with diseases with 'chronic fatigue' manifestiations.

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Other Infectious Diseases:

Diagnosis and treatment of other bacterial, viral, fungal and parasitic infections in children and adolescents and adults

  • Chronic and recurrent infections
  • Respiratory diseases e.g. tuberculosis (TB)
  • Recurrent Urinary Tract Infections
  • Skin infections and dermatological problems
  • Other complicated infections e.g. osteomyelitis (bone infection)
  • Chronic Fatigue Syndrome (CFS)

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Travel/Tropical Medicine:

Pre and post travel evaluations, vaccinations, treatment and advice. The following vaccinations are available:

  • Cholera
  • Hepatitis A
  • Hepatitis B
  • Influenza
  • Meningitis Type A
  • Polio
  • Rabies
  • Tetanus and Diphtheria
  • Typhoid
  • Yellow Fever

The following preventative treatments are available:

  • Malaria prophylaxis
  • Diarrhoea prophylaxis
  • PEP – HIV prophylaxis

Ideally, it is best to present for your vaccinations and advice some 6 weeks before departure date to ensure that all vaccination courses can be completed before travel.

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Get In Touch

If you have a question or a comment (reg. appointment, availability etc.) please complete our enquiry form and we will get back to you as soon as possible. Your non-medical query only.

Dr John Lambert (MD, PhD)

Dr Lambert is a consultant at the Mater and Rotunda hospitals in Dublin, specialising in Infectious Diseases including Lyme Disease and Chronic Fatigue Syndrome

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Location & Contact

Address for Private Clinic:

The Catherine McAuley Educational & Research Centre,
Nelson Street (just off Eccles Street),
Dublin 7

General Queries:
+353 (0)76 680 3364 - Administration Working Hours 09:30 - 12:30 Hours Monday through Friday

+353 (0)1 716 4535/4537

Hours of Operations

Tuesday & Thursday afternoons 13:00-17:00.