How to treat a Borrelia tick bite? - briefly
Extract the attached tick with fine‑tipped tweezers, disinfect the bite site, and start a prophylactic doxycycline regimen (100 mg once daily for 10–14 days) if removal occurs within 72 hours and the tick is identified as a Borrelia carrier. Obtain medical evaluation promptly to confirm infection and modify therapy if necessary.
How to treat a Borrelia tick bite? - in detail
When a tick that may carry Borrelia burgdorferi attaches to the skin, immediate removal is essential. Grasp the tick’s head with fine‑point tweezers, pull straight upward with steady pressure, and avoid crushing the body. After extraction, cleanse the site with an antiseptic solution and allow it to air‑dry. Document the date of the bite, the tick’s appearance, and any symptoms that develop.
If the bite occurs in an area where Lyme disease is endemic and the tick has been attached for 36 hours or longer, a single dose of doxycycline 200 mg is recommended as prophylaxis, provided the patient is not pregnant, under eight years old, or allergic to tetracyclines. Alternative regimens include amoxicillin 2 g once or cefuroxime axetil 400 mg twice, administered within 72 hours of removal.
Observe the area for the emergence of erythema migrans—an expanding, red, annular rash typically appearing 3–30 days after exposure. If the lesion develops, initiate a full treatment course:
- Doxycycline 100 mg orally twice daily for 14–21 days (first‑line for adults).
- Amoxicillin 500 mg orally three times daily for 14–21 days (alternative for children, pregnant, or doxycycline‑intolerant patients).
- Cefuroxime axetil 250 mg orally twice daily for 14–21 days (second‑line option).
For patients presenting with neurologic, cardiac, or articular manifestations, intravenous ceftriaxone 2 g daily for 14–28 days is indicated. Oral regimens may be continued after the initial IV phase if required.
Serologic testing (ELISA followed by Western blot) should be performed only after the rash appears or if systemic signs develop; testing before seroconversion yields unreliable results. Positive results guide the decision to extend therapy beyond the standard course.
Follow‑up visits at two‑week intervals assess symptom resolution, rash regression, and potential adverse drug reactions. Persistent fatigue, joint pain, or neurological deficits after treatment warrant referral to an infectious‑disease specialist for possible retreatment or adjunctive therapy.
Preventive measures include wearing long sleeves, applying EPA‑registered repellents containing DEET or picaridin, and performing daily body checks after outdoor activities in tick‑infested regions. Prompt removal and appropriate antimicrobial intervention markedly reduce the risk of chronic infection.