Tick bite or just bug bite?

On vacation in Florida earlier this month, I woke up one morning with 15-20 very itchy bites, and suspected bed bugs. (Never found out, because I had to check out early that morning and catch a train.) Over the following week, the bites and itching cleared up . . . except when I got home exactly one week later I discovered a bulls-eye rash on my upper arm. I was in a doctor's office within an hour. After a visit to another doctor the next day, he confirmed Lyme as well and I went on the antibiotic protocol that afternoon, despite not having any symptoms yet.

Everywhere I read on the web, the bulls-eye rash seems to be the official stamp of Lyme. But how on earth do I contract Lyme in Florida, in the winter, while never going near the woods or any bushes? (Ironically, I live in the northeast, which is Ground Zero for Lyme.) I still think the rash may be just from a fancy spider bite, but I'm continuing with my 21 days of Doxy.

Anyway, my rash is almost gone; it is NOT expanding like it is supposed to (or so I've read), but is that because of the antibiotics? Thanks for any replies; I'm obviously new to all of this.

Oh, welcome, I just noted that this is your first post!

We encourage all new members to read our intro (top topic) "New to Lyme?......start here".

It's our cliff notes on comparing symptoms to organisms, getting treatment and help getting through treatment as easily as we can.

Well, first is that there is nothing else that does a bull's eye rash. Only lyme. So sorry. It is the definitive test for lyme and you now can save a lot of money on further testing.

Also, not only is lyme transmitted via ticks, but it is also transmitted by other avenues. So the list grows on where you could have gotten it.

Which it doesn't really matter at this point. You got the rash. So was it a mosquito bite or a flea? Who knows.

I didn't even see the tick that bit me. Because it was April, I assume that it was a nymph. Sneaky lil bugger!

My rash was localized to just one spot on my arm. Now my second LLMD said he got a rash and it spread all over his torso, so there ya go.

One thing I learned about lyme is that it is different for each one of us.

I am so sorry you have lyme and I do hope that it was caught quickly enough that the abx work and you don't have any other symptoms.

I have a girlfriend that got a bite and she got doxy immediately and she has no symptoms and it has been a year. So there is a possibility.

Hang in there and don't overdo anything. Overdoing taxes your immune system and that will let your guard down on fighting those buggers.

On the flip side of PeteZa's girlfriend you could be like me. I got on two rounds of Doxy pronto after my bite which had the bulls eye, yet here I sit 11/2 years later still fighting it. If you start having weird symptoms I'd advise you to find a LLMD soon! Look at the list of symptoms in the New to Lyme at the top and keep them stored in the back of your head so you have some idea of what you could have next. I didn't have the flu symptoms or joint pain... just random weird twitching and headache. Everyone reacts differently which is why Lyme is so hard to treat.

I hope the Doxy works for you!!

Welcome Roberts89. The good news is that you recognized it quickly and started treatment. The not so good news is that you need to go back to your dr and request that he add Azithromycin to the protocol. Doxy will cause the spirochettes to go into a dormant round body form, unaffected by the doxy, waiting for the abx to clear. The azith will work on the round body forms as well. You might also look into biofilm disruption, because they will hide there and hide. You have the edge because you are early. Don't lose it by doing half measures. Time is of the essence.

Welcome Roberts

You need to treat for 6 weeks minimum - take a look at the Lyme Disease Treatment Guidelines:

www.lymenet.org/BurrGuide200810.pdf

Scroll down to page 19 - to "Early Localized"

"EARLY LOCALIZED - Single erythema migrans with no constitutional symptoms:
1) Adults: oral therapy- must continue until symptom and sign free for at least one month,
with a 6 week minimum."

Also, what is your dose? You need to be taking 200 mg twice daily (alright to start lower - at 100 mg twice daily, but within a couple weeks - need to increase)

Please do not under treat this...your chances of this being not becoming chronic is best now...

Roberts - I posted a link to the guidelines in my post. (ILADS)

www.ilads.org/lyme/treatment-guideline.php

If you click on that link above and then scroll down to this section:

Diagnostic Hints and Treatment Guidelines for Lyme and Other Tick Borne Illnesses:
by Joseph J. Burrascano Jr., MD

and click on the link Download Guidelines - it will take you there - just a different way to get there.

If you read what you quoted in your post - "The only U.S. guidelines in compliance.....are those established in 2015 by the International Lyme and Associated Diseases Societ (ILADS).

So, the ones to follow are the ILADS guidelines.
The IDSA guidelines were removed.


To answer your question: advising stronger /longer treatment - based on both experience and established guidelines. The guidelines were compiled by Dr. Joseph Burrascano - he is an experienced Lyme Literate Dr. who had lyme disease himself.

Time and time again, we have people coming here who were undertreated...and are now having to treat chronic lyme.
The bacteria becomes persistent and harder to treat once it's left too long.
If you're going to treat for 3 weeks, why not treat for 6 or 8 weeks. A few more weeks is better than the risk of chronic lyme developing.

Roberts89 said...
I really appreciate the responses so far. For those of you advising stronger or longer treatment: Do you base that on your own experience or on established guidelines? I wonder what you think of this paragraph from my state's main resource page on Lyme:

"There is controversy about the proper treatment for Lyme disease. As of February, 2016, the Infectious Disease Society of America (IDSA) guidelines were removed from the National Guidelines Clearinghouse (NGC). The only U.S. guidelines in compliance with current NGC standards are those established in 2015 by the International Lyme and Associated Diseases Society (ILADS)."

I guess I'm wondering what agency or body has the most authority on the issue, or if there is so much controversy that patients really just have to chart their own course. I'm seeing a naturopath but don't know on what guidelines he bases his treatment.

For the record, my current protocol is 100mg of Doxy, twice a day for 21 days. I began this before any symptoms (beyond the rash).

Here is a link to the National Guidelines Clearinghouse for the treatment of Lyme - it was changed to the ILADS treatment guidelines on Nov. 2015 - even though there is still a lot of arguing going on: /www.guideline.gov/summaries/summary/49320
"Q2. Should the treatment of an erythema migrans (EM) rash be restricted to 20 or fewer days of oral azithromycin, cefuroxime, doxycycline and phenoxymethylpenicillin/amoxicillin?

Recommendation 2a

Treatment regimens of 20 or fewer days of phenoxymethylpenicillin, amoxicillin, cefuroxime or doxycycline and 10 or fewer days of azithromycin are not recommended for patients with EM rashes because failure rates in the clinical trials were unacceptably high. Failure to fully eradicate the infection may result in the development of a chronic form of Lyme disease, exposing patients to its attendant morbidity and costs, which can be quite significant. (Recommendation, very low-quality evidence)."

And for more on this (ILADS vs IDSA), you can read these articles:
​​
ILADS vs IDSA:
www.clinicaladvisor.com/controversy-continues-to-fuel-the-lyme-war/article/117160/

archinte.jamanetwork.com/article.aspx?articleid=226373

www.ncbi.nlm.nih.gov/pmc/articles/PMC2901226/