What should be done for Lyme disease after a tick bite? - briefly
Immediately remove the tick with fine tweezers, disinfect the bite site, and note the attachment time; if the tick was attached for more than 36 hours in an area where Lyme disease is prevalent, a single dose of doxycycline is advised as prophylaxis. Seek medical evaluation promptly and begin a full course of antibiotics if early symptoms appear.
What should be done for Lyme disease after a tick bite? - in detail
After a tick attachment, immediate removal is critical. Grasp the tick with fine‑point tweezers as close to the skin as possible, pull upward with steady pressure, and avoid crushing the body. Disinfect the bite site with an antiseptic solution.
If the tick has been attached for less than 24 hours, prophylactic antibiotics are not routinely required. When removal occurs after 36 hours or more, or when the tick is identified as Ixodes scapularis in a region with high prevalence of Borrelia burgdorferi, a single dose of doxycycline (200 mg for adults, 4 mg/kg for children ≥8 years) is recommended within 72 hours of removal. Contraindications (pregnancy, allergy, age <8 years) call for alternative agents such as amoxicillin (500 mg twice daily for 10 days) or cefuroxime axetil (250 mg twice daily for 10 days).
Observation for early signs should continue for at least 30 days. Key clinical indicators include:
- Erythema migrans: expanding red rash, often with central clearing, appearing 3–30 days post‑bite.
- Flu‑like symptoms: fever, chills, headache, fatigue, myalgia, arthralgia.
- Neurological manifestations: facial palsy, meningitis, radiculitis.
- Cardiac involvement: atrioventricular block, myocarditis.
If erythema migrans or systemic symptoms develop, initiate a full treatment course. Preferred regimens are:
- Doxycycline 100 mg twice daily for 14–21 days (adults and children ≥8 years).
- Amoxicillin 500 mg three times daily for 14–21 days (children <8 years, pregnant or lactating women).
- Cefuroxime axetil 250 mg twice daily for 14–21 days (alternative for doxycycline intolerance).
Serologic testing (ELISA followed by Western blot) is reserved for patients with objective signs beyond the rash or for those with delayed presentation. Positive results guide extended therapy, especially in cases of neuroborreliosis or Lyme arthritis, where intravenous ceftriaxone (2 g daily for 14–28 days) is indicated.
Preventive measures include wearing long sleeves and pants, applying EPA‑registered repellents containing DEET or picaridin, and performing thorough body checks after outdoor exposure. Regular landscape management to reduce tick habitat further lowers risk.