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Possible New Lyme/allergic reaction to bite

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Posted 4/30/2018 2:11 PM (GMT -5)
Hello,

I live in an endemic area and I'm constantly pulling ticks off myself and my family, without panic. I would consider myself fairly well read on tick identification and lyme prevention. We went for a trail walk early Saturday morning. Mid-day Saturday I found a deer tick embedded on my inner thigh. I removed it with a tick twister. Late Sunday night, a rash with what seemed to be a clear bulls-eye pattern about two inches across appeared at the bite site. This morning (Monday), the rash had expanded about another inch, but the bulls-eye was much less defined and the rash was more solid red.

I went to urgent care first thing this morning. I did bring a photo of the more defined rash from the night before. The NP there said it was too early for an EM rash to be developing, and since I'm asymptomatic otherwise, it was probably just an allergic reaction to the bite itself.

She suggested we wait and see if I become symptomatic, but I advocated for antibiotic treatment, because everything I've read said lyme treatment is most effective when it's undertaken quickly, and the bite/rash combination didn't sit well with me.

I did leave with a script for 100 mg doxycyline 2x/day for 20 days, but I had to fight for it, and now I'm second guessing myself. I don't want to take a 20-day course of antibiotics unnecessarily.

Has anyone ever had experience with an allergic reaction mimicking an EM rash? Is there any way to test the difference? Would you take the antibiotics or wait to see if you became symptomatic?

Thank you!
Posted 4/30/2018 2:22 PM (GMT -5)
I would take the medicine if I were in your shoes. I think the chances for bad a reaction to 20 days of Doxycycline is minimal compared to potential of letting infections take root in your body. I didn't have a prototypical bulls-eye either. I had a red lump with 1.25" diameter solid red rash. I wish I would have done something earlier...

Although knowing what I know now, the doctor would have probably just turned me away anyway.

My health degraded over the next couple of years before I finally sought treatment with an LLMD.

I recommend that you take the Doxycylcline and continue to closely watch for ANY symptoms to develop. If any symptoms develop, get to an LLMD as soon as you can.
Posted 4/30/2018 3:23 PM (GMT -5)
Thanks, Missouri.
That's what I was thinking was the best bet. I hope your health is improving.
Posted 4/30/2018 4:41 PM (GMT -5)
KateGee - sorry about the tick bite

The EM is diagnostic - you really should be on 200 mg twice daily of doxy for a minimum 6 weeks.

I will double check the guidelines and correct if the number of weeks is different.

Edit: here’s what the guidelines say:

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.
2) Pregnancy: 1st and 2nd trimesters: I.V. X 30 days then oral X 6 weeks
3rd trimester: Oral therapy X 6+ weeks as above.
Any trimester- test for Babesia and Ehrlichia 3) Children: oral therapy for 6+ weeks.
Posted 4/30/2018 6:02 PM (GMT -5)
Wow. Thank you. I was really not happy with the medical input I received today. At least I have theee weeks of antibiotics to start. Thank you for the info. I’ll make a followup elsewhere.
D
Posted 4/30/2018 10:40 PM (GMT -5)
The prevention dose of doxy is 1= 200 mg if the tic bite is 12-24 hrs of bite if longer say 24-72 hrs it is 200 mg a day twice 12hr apart for three days. If you have a bullseyes rask the treatment is 200mg for 30 days that is the scoop and you need to take 30days not if or ands about it. Please do it I do not want you like me. Praying for you
Posted 5/1/2018 2:11 AM (GMT -5)

Donjr said...
The prevention dose of doxy is 1= 200 mg if the tic bite is 12-24 hrs of bite if longer say 24-72 hrs it is 200 mg a day twice 12hr apart for three days. If you have a bullseyes rask the treatment is 200mg for 30 days that is the scoop and you need to take 30days not if or ands about it. Please do it I do not want you like me. Praying for you

6 weeks minimum for bullseye rash - refer to ILADS guidelines.
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