Lyme disease / tick bites

• Tick bites (lyme disease): prophylaxis (72 hrs after tick removal not routinely recommended): doxy 200mg STAT.

• Treatment: doxy 100mg BD 21/7 (alternative: Amoxi 1g TDS 21/7). Pregnancy/BF: Amoxi 1g TDS 21/7.

• Spirochete borrelia burgdorferi via tick bite. Early: erythema migrans rash (also known as erythema chronicum migrans), flu-like symptoms, with possible neurological, and cardiac involvement.

• Oral antibiotics (doxycycline), caution re Jarisch-Herxheimer reaction and check serology (ELISA). Late: neurological, joint, or skin involvement (e.g acrodermatitis chronica atrophicans), can develop months or years after the initial infection. Post-infection syndrome reported, similar to chronic fatigue syndrome. Lyme disease (NHS Choices), Lyme disease (CKS), Lyme disease (and erythema migrans) (PCDS), Lyme disease (gov.uk)