If I Take Antibiotics To Prevent Lyme And Then Have A Negative Test Am I Lyme
If you do receive prophylactic treatment, be cautious in in interpreting the results of subsequent testing. Widely-used blood tests look for antibodies to Borrelia burgdorferi, but early treatment can prevent the body from mounting an antibody response. Should you become infected despite prophylactic treatment, subsequent tests results couldbe falsely negative.
What Should You Do If You Find A Tick
Don’t touch the tick with your bare hand.
Use a pair of tweezers to remove the tick. Grab the tick firmly by its mouth or head as close to your skin as possible.
Pull up slowly and steadily without twisting until it lets go. Don’t squeeze the tick, and don’t use petroleum jelly, solvents, knives, or a lit match to kill the tick.
Save the tick. Place it in a plastic container or bag so it can be tested for disease, if needed.
Wash the bite area well with soap and water and put an antiseptic lotion or cream on the site.
What Causes Lyme Disease
Lyme disease is caused by bacteria. In the United States, this is usually a bacterium called Borrelia burgdorferi. It spreads to humans through the bite of an infected tick. The ticks that spread it are blacklegged ticks . They are usually found in the:
- Upper Midwest
- Pacific coast, especially northern California
These ticks can attach to any part your body. But they are often found in hard-to-see areas such as your groin, armpits, and scalp. Usually the tick must be attached to you for 36 to 48 hours or more to spread the bacterium to you.
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How Is Ld Treated
Treatment of LD should follow the clinical practice guidelines by the Infectious Diseases Society of America and the American Academy of Pediatrics .
There has been a shift to using shorter durations of antimicrobials and to more permissive use of oral drugs in select circumstances . Additionally, data on the safety of short courses of doxycycline for children < 8 years old, coupled with its proven efficacy for treating LD, including meningitis, has prompted more permissive use of this antimicrobial.
Arthritis frequency has decreased in the United States, probably because of improved recognition and earlier treatment of patients with early LD. Up to one-third of LD patients with arthritis experience residual synovitis and joint swelling, which almost always resolve without repeating the antibiotic course. For patients who have persistent or recurrent joint swelling after a recommended course of oral antibiotic therapy, some experts recommend retreatment with another four-week course of oral antibiotics or with a course of parenteral ceftriaxone. For cases with ongoing arthritis, consultation with an expert is recommended. Consider hospitalization and constant monitoring for a child with heart block and syncope that may rapidly worsen enough to require a pacemaker.
The Jarisch-Herxheimer reaction can occur when therapy is initiated. Nonsteroidal anti-inflammatory agents should be started and the antimicrobial agent continued.
How Is The Diagnosis Of Ld Made
Testing should be carried out at an approved provincial, territorial or national public health laboratory in Canada. Test results from private laboratories not approved by Health Canada, provincial or territorial governments cannot be relied upon for accuracy nor validity.
Early, localized disease: In general, the diagnosis of LD is clinical , supported by a history of potential tick bite in an area where it is known or suspected that black-legged ticks have been established. However, because tick populations are expanding, it is possible that LD can be acquired outside of currently identified areas. Such a possibility should be considered when assessing patients. Patients with EM should be diagnosed and treated without laboratory confirmation, because antibodies against B burgdorferi are often not detectable by serodiagnostic testing within the first four weeks after infection .
Later disease: All other clinical manifestations of possible LD should be supported by laboratory confirmation. Two-tiered serological testing, including an ELISA screening test followed by a confirmatory Western blot test, is used to supplement clinical suspicion of extracutaneous LD . Two-tiered testing is necessary because the ELISA may yield false-positive results from antibodies directed against other spirochetes, viral infections or autoimmune diseases. Table 1 provides information related to the performance characteristics of serological assays in different clinical presentations of LD.
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Where Do Ticks Live
Ticks live outdoors. They hide in grass, trees, shrubs, and underbrush.
If youre outside hiking or playing, a tick might attach itself to you or your pet. Ticks may stay attached to your pet, or they can migrate to you while youre touching or holding your pet. They can also leave you and attach themselves to your pets.
Various kinds of ticks live in large populations throughout the country. Most states have at least one type of tick that lives there. Ticks are at their peak population in the spring and summer months, typically April through September.
Treatment For Erythema Migrans
People treated with appropriate antibiotics in the early stages of Lyme disease usually recover rapidly and completely. Early diagnosis and proper antibiotic treatment of Lyme disease can help prevent late Lyme disease.
Treatment regimens listed in the following table are for the erythema migrans rash, the most common manifestation of early Lyme disease. These regimens may need to be adjusted depending on a persons age, medical history, underlying health conditions, pregnancy status, or allergies. Consult an infectious disease specialist regarding individual patient treatment decisions.
|100 mg, twice per day orally||N/A|
|500 mg, three times per day orally||N/A|
|500 mg, twice per day orally||N/A|
|4.4 mg/kg per day orally, divided into 2 doses||100 mg per dose|
|50 mg/kg per day orally, divided into 3 doses||500 mg per dose|
|30 mg/kg per day orally, divided into 2 doses||500 mg per dose|
*When different durations of antibiotics are shown to be effective for the treatment of Lyme disease, the shorter duration is preferred to minimize unnecessary antibiotics that might result in adverse effects, including infectious diarrhea and antimicrobial resistance.
NOTE: For people intolerant of amoxicillin, doxycycline, and cefuroxime, the macrolide azithromycin may be used, although it is less effective. People treated with azithromycin should be closely monitored to ensure that symptoms resolve.
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What Are The Stages Of Lyme Infection
There are three stages:
- Early localized Lyme: Flu-like symptoms like fever, chills, headache, swollen lymph nodes, sore throat, and a rash that looks like a bull’s-eye or is round and red and at least 2 inches long
- Early disseminated Lyme: Flu-like symptoms like pain, weakness, or numbness in your arms and legs, changes in your vision, heart palpitations and chest pain, a rash , and a type of facial paralysis known as Bellâs palsy
- Late disseminated Lyme: This can happen weeks, months, or years after the tick bite. Symptoms might include arthritis, severe fatigue and headaches, dizziness, trouble sleeping, and confusion.
About 10% of people treated for Lyme infection donât shake the disease. They may go on to have three core symptoms: joint or muscle pain, fatigue, and short-term memory loss or confusion. This is called post-treatment Lyme disease syndrome. It can be hard to diagnose because it has the same symptoms as other diseases. Plus, there isn’t a blood test to confirm it.
Experts arenât sure why Lyme symptoms donât always go away. One theory is that your body keeps fighting the infection even after the bacteria are gone, like an autoimmune disorder.
Inspection And Tick Removal
Because recommendations for avoidance are not always practical, particularly for children and during the summer, daily close inspection for ticks should be performed each time one has been outdoors. Parents of children in endemic areas must be vigilant to check for ticksespecially the nymphs, because of their smaller size from the spring to the fall. Checking inside skin folds, behind ears, the umbilicus, groin, axilla, hairline, and scalp must be routine. If one tick is found, search thoroughly for others.
See the image below for a tick removal diagram and instructions.
While these instructions may represent the optimal method for removing the tick, it is more important to remove it promptly than to delay removing it while obtaining forceps or gloves.
A common misperception is that pressing a hot match to the tick or trying to smother it with petroleum jelly, gasoline, nail polish, or other noxious substances is beneficial. This only prolongs exposure time and may cause the tick to eject infectious organisms into the body. Finally, do not squeeze, crush, or puncture the body of the tick because its fluids may contain infectious organisms.
Once the tick is removed, wash the bite area with soap and water or with an antiseptic to destroy any contaminating microorganisms. Additionally, the person who removed the tick should wash his or her hands. The removed tick should be submitted for species identification.
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What Are The Risk Factors For Post Treatment Lyme Disease
Risk factors for Post Treatment Lyme Disease include:
- Delay in diagnosis
- Increased severity of initial illness
- Presence of neurologic symptoms
Increased severity of initial illness, the presence of neurologic symptoms, and initial misdiagnosis increase the risk of Post Treatment Lyme Disease. PTLD is especially common in people that have had neurologic involvement. The rates of Post Treatment Lyme Disease after neurologic involvement may be as high as 20% or even higher. Other risk factors being investigated are genetic predispositions and immunologic variables.
In addition to Borrelia burgdorferi, the bacteria that causes Lyme disease, there are several other tick-borne co-infections that may also contribute to more prolonged and complicated illness.
The Following Are The Most Common Misunderstood Facts About Tick Bites:
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Lyme Disease: Symptoms And Stages
Symptoms of early-stage Lyme disease include:
- muscle and joint aches
- swollen lymph nodes
Another common symptom of Lyme disease is a rash . As many as 80% of infected people may develop a rash, and roughly 20% of the time the rash has a characteristic bull’s-eye appearance.
When left untreated, infection can spread to joints, the heart, and the nervous system.
Later-stage symptoms may not appear until weeks or months after a tick bite occurs. They include:
- heart-rhythm irregularities
- nervous system abnormalities
Permanent damage to the joints or the nervous system can develop in patients with late Lyme disease. It is rarely, if ever, fatal.
What Do I Do If I Find A Tick On My Skin
Dont panic. Use fine-tipped tweezers to grasp the tick as close to the skins surface as possible. Pull up with steady, even pressure. Be careful not to squeeze or twist the tick body. Sometimes parts of the tick remain in the skin. You can leave them alone or carefully remove them the same way you would a splinter. Do not use heat , petroleum jelly, or other methods to try to make the tick back out on its own. These methods are not effective.
Wash the area where the tick was attached thoroughly with soap and water. Keep an eye on the area for a few weeks and note any changes. Call your doctor if you develop a rash around the area where the tick was attached. Be sure to tell your doctor that you were bitten by a tick and when it happened.
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Ways You Can Prevent A Tick Bite
If you spend time outdoors its important to know how to spot a tick bite, learn to safely remove a tick, and when to seek medical care for Lyme disease or other tick-borne illnesses. Peak tick season runs from May to October and if you spend any time outdoors, its wise to know how to spot a tick bite, know how to remove a tick safely, and when to seek medical care.
- Treat your clothing and outdoor gear with 0.5 percent permethrin.
- Use a tick repellent with at least 20 percent DEET.
- Walk in the center of marked trails.
- Wear a long-sleeved shirt and pants when outdoors.
To learn more about tick prevention, head to 7 tips to keep you tick-free.
Can Lyme Disease Be Prevented Or Avoided
The best way to prevent Lyme disease is to avoid being bitten by ticks. When you are outdoors, follow these guidelines:
- Avoid areas that are wooded, brushy, or have tall grass.
- Walk in the center of trails.
- Use an insect repellent with at least 20% DEET. It can be put on clothing or sparingly on the skin. Dont apply it to the face or hands of children.
- Treat clothing, tents, or other gear with repellents containing 0.5% permethrin.
- Wear light-colored clothing. This makes it easier to see and remove ticks from your clothes.
- Wear a long-sleeved shirt and long pants. Tuck your pant legs into your socks or boots for added protection.
After you get home, check everything and everyone for ticks.
- Bathe or shower as soon as you can to wash off any ticks that have not attached to you.
- Check your entire body for ticks. Use a mirror for places you cant see. Check your children and your pets. Common tick locations include the back of the knees, groin area, underarms, ears, scalp, and the back of the neck.
- Check any gear you used, including coats, backpacks, or tents.
Tumble dry clothes or blankets on high heat in the dryer for 10 to 15 minutes. This should kill any ticks. If clothes are dirty, wash them in hot water and dry on high heat for 60 minutes.
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Ongoing Symptoms Of Lyme Disease
A few people who are diagnosed and treated for Lyme disease continue to have symptoms, like tiredness, aches and loss of energy, that can last for years.
These symptoms are often compared to fibromyalgia and chronic fatigue syndrome.
It’s not clear why this happens to some people and not others. This means there’s also no agreed treatment.
Speak to a doctor if your symptoms come back, or do not improve, after treatment with antibiotics.
The doctor may be able to offer you further support if needed, such as:
- referral for a care needs assessment
- telling your employer, school or higher education institution that you require a gradual return to activities
- communicating with children and families’ social care
Page last reviewed: 05 July 2021 Next review due: 05 July 2024
How To Remove A Tick And Treat A Tick Bite
Its a good idea to take a shower or bath within a couple hours of returning home after youve been outside in tick habitat. Check your body carefully, especially in your hair, behind your ears, between your legs and behind your knees, all those spots that are not easily visible are great spots for ticks. Keep a small sealed container filled with rubbing alcohol and a tweezers ready in case you find a tick. An empty prescription bottle works well for this. If you do find a tick, use the tweezers or similar tool and:
- Grasp the tick as close to your skin as possible.
- Use steady pressure and pull straight up try not to bend, twist or squeeze the tick.
- Place the tick in the alcohol filled container and close tightly.
- Clean the area thoroughly with soap and water.
- While the goal is to remove the entire tick, I dont recommend digging into your skin to remove any remaining parts of the tick because this may lead to an open sore and increase your chance for a skin infection.
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What’s The Best Way To Prevent A Tick Bite
Ticks can’t fly or jump. But they live in shrubs and bushes and can grab onto you when you pass by. To avoid getting bitten:
- Wear pants and socks in areas with lots of trees and when you touch fallen leaves.
- Wear a tick repellent on your skin and clothing that has DEET, lemon oil, or eucalyptus.
- For even more protection, use the chemical permethrin on clothing and camping gear.
- Shower within 2 hours after coming inside. Look for ticks on your skin, and wash ticks out of your hair.
- Put your clothing and any exposed gear into a hot dryer to kill whatever pests might be on them.
How do you know if you’ve been bitten?
Since ticks are so small, you’ve got to have pretty good eyes to see them.
If you have a small, red bump on your skin that looks like a mosquito bite, it could be a tick bite. If it goes away in a few days, itâs not a problem. Remember, a tick bite doesnât necessarily mean you have Lyme disease.
If you notice a rash in the shape of a bull’s-eye, you might have a tick bite. Talk to your doctor about treatment.
If you have an allergic reaction to ticks, you’ll notice a bite right away.