What should be done after a tick bite that causes Lyme disease?

What should be done after a tick bite that causes Lyme disease? - briefly

Prompt medical assessment and laboratory testing for Borrelia infection are required. If confirmed or strongly suspected, begin a course of doxycycline (or an appropriate alternative antibiotic) without delay.

What should be done after a tick bite that causes Lyme disease? - in detail

A tick bite that carries Borrelia burgdorferi requires immediate and systematic action to reduce the risk of Lyme disease progression.

• Remove the tick promptly. Use fine‑point tweezers, grasp the mouthparts as close to the skin as possible, and pull upward with steady pressure. Disinfect the bite area with an antiseptic after extraction.
• Document the encounter. Note the date of the bite, the geographic location, and the estimated duration of attachment, as these factors influence treatment decisions.
• Assess for early signs. Within 3‑30 days, a characteristic expanding erythema (often called a “bull’s‑eye” rash) may appear, accompanied by flu‑like symptoms such as fever, headache, fatigue, or muscle aches. Absence of rash does not exclude infection.
• Initiate prophylactic antibiotic therapy when appropriate. The Centers for Disease Control and Prevention recommends a single dose of doxycycline (200 mg for adults, 4 mg/kg for children ≥8 years) if all of the following criteria are met:
  1. The tick is identified as Ixodes scapularis or Ixodes pacificus.
  2. The tick has been attached for ≥36 hours.
  3. Local infection rates of B. burgdorferi exceed 20 %.
  4. The patient is not allergic to doxycycline, is not pregnant, and is older than 8 years.
• If prophylaxis is not indicated, schedule a clinical follow‑up within 2‑4 weeks. During the visit, perform a thorough physical examination and consider serologic testing if symptoms develop.
• For confirmed early localized infection, prescribe a full course of oral doxycycline (100 mg twice daily for 10‑21 days). Alternatives for contraindicated patients include amoxicillin (500 mg three times daily) or cefuroxime axetil (500 mg twice daily) for the same duration.
• Monitor treatment response. Resolution of rash and systemic symptoms typically occurs within days. Persistent or recurrent manifestations warrant re‑evaluation, possible extension of therapy, or referral to an infectious‑disease specialist.
• Educate on prevention for future exposures: wear long sleeves and pants, apply EPA‑registered repellents, conduct regular tick checks, and perform prompt removal.

Adhering to this protocol maximizes the likelihood of preventing disseminated Lyme disease and its complications.