Is this a Lyme rash?

We went on a nature walk on Saturday ( 5 days ago ) and on Monday I noticed this rash on my 2.5 year old, around what I thought was a mosquito bite.

(photo removed)

Does this look like Lyme? So far, I haven't noticed any symptoms, but I'm extremely concerned.

His pediatrician brushed it off and said if we did not see a tick, it is not a concern, but I'm not convinced.

Post Edited (mamatee) : 8/4/2017 1:22:07 PM (GMT-6)

Thanks, Girlie.

He has not had any symptoms yet. We are in the Toronto area, and I know Canadian doctors are not allowed to treat Lyme. I can probably convince his pediatrician to prescribe whatever I ask for, but I'm not really sure what to ask for.

I will check their website for the guidelines. thanks!

From what I am seeing, he should be getting 50mg/kg/day divided into 3 doses, for 30 days. Does that sound about right?

I agree with Girlie. We would be lying if we said it didn't look like it.

Amazing how misinformed professional doctors can be. If a tick can be as small as the period at the end of this sentence, then how are you supposed to "see" it.

You can email me and I will check for Dr.s - there may be a Lyme friendly one.

Sorry - I never posted a link to the guidelines

www.lymenet.org/BurrGuide200810.pdf

(Look at Early Localized below)

TICK BITES - Embedded Deer Tick With No Signs or Symptoms of Lyme (see appendix):
Decide to treat based on the type of tick, whether it came from an endemic area, how it was removed,
and length of attachment (anecdotally, as little as four hours of attachment can transmit pathogens). The risk of transmission is greater if the tick is engorged, or of it was removed improperly allowing the tick's contents to spill into the bite wound. High-risk bites are treated as follows (remember the possibility of co-infection!):
1) Adults: Oral therapy for 28 days.
2) Pregnancy: Amoxicillin 1000 mg q6h for 6 weeks. Test for Babesia, Bartonella and Ehrlichia.
Alternative: Cefuroxime axetil 1000 mg q12h for 6 weeks. 3) Young Children: Oral therapy for 28 days.
EARLY LOCALIZED - Single erythema migrans with no constitutional symptoms:
1) Adults: oral therapy- must continue until symptom and sign free for at least one month,
with a 6 week minimum.
2) Pregnancy: 1st and 2nd trimesters: I.V. X 30 days then oral X 6 weeks
3rd trimester: Oral therapy X 6+ weeks as above.
Any trimester- test for Babesia and Ehrlichia 3) Children: oral therapy for 6+ weeks.
DISSEMINATED DISEASE - Multiple lesions, constitutional symptoms, lymphadenopathy, or any other

No, don't discontinue because the EM is a sign/symptom of lyme disease.

If she gets any other symptoms (which can be difficult to determine with a toddler) - then the treatment extends.

I will check my emails in a bit.

mamatee said...

Does this look like Lyme? So far, I haven't noticed any symptoms, but I'm extremely concerned.
His pediatrician brushed it off and said if we did not see a tick, it is not a concern, but I'm not convinced.

YES, it's a lyme rash, wow, it looks almost like the wikipedia rash which is the "perfect" one. they are not always that obvious, sometimes it's just a red spot, sometimes there's NOTHING....

give him antibiotics ASAP, you have the opportunity to kill it from the start, both doxy and amoxicillin are very effective given this early and very high chances to achieve a cure.

jeez if THAT is not recognized by a pediatrician, then what is ?! they should learn about it in school, it has THAT SHAPE EXACTLY....

mamatee said...
So, how do I know if I need to discontinue or extend after 6 weeks?

Thank you SO much for your help. This advice is priceless!!!

Keep a close watch on him. If he has pain or any other symptoms - extra fussy, etc.

What you can also try - go to a walk-in clinic and ask for antibiotics.
Then go to another clinic and ask for antibiotics again...
That way you can get her started right away and you may get a few weeks from each Dr.

I will send you the name of a Lyme 'friendly' GP in Ontario (I think it's Toronto) who should be able to give him several weeks of abx. When you phone - make sure you say it has just recently occurred.

I am also giving you a name of a LLMD in Plattsburgh, NY who you can contact if necessary.
She has treated another child from Ontario.

There are LLND's in Ontario - but they only treat herbally. (Unless things have changed recently, the ND"s aren't able to prescribe abx)

I'm going to check my emails now and send you the names.



mpost: Unfortunately most Dr.'s won't recognize a bulls eye rash here in Canada as needing treatment for LD.

He will also need to be on probiotics...go to a health food store for those.

mamatee said...
Thanks for the link, Girlie! Looks like it's 6+ weeks of treatment. Do I start at 6 weeks and discontinue if there are no symptoms?

I sent you an email about finding a doctor.

I think misunderstood what you said here.

If there are no other symptoms and the EM has resolved - you stop at the 6 weeks.

Sorry for the confusion.

Good for you - convincing the Dr. for the 6 weeks.

Reminder: probiotics.

So 8:00 a.m. (or shortly after) before he has breakfast; 1:00 p.m. (with a snack or late lunch?) and 7:00 p.m. (again, with something to eat)

We don't want the abx to upset his stomach, so following it with food is a good idea.

then at 9:00 probiotics - and then bed at 9:30.

You could slip in the other dose of probiotics either at 10:00 a.m. or 3:00 p.m. (2 hours after abx)

It's best to have one dose of the probiotics at the end of all doses (2 hours after) of abx - so the good bacteria can populate throughout the night.
you don't want to take abx right after the probiotics - as they will kill off the good bacteria you're trying to replenish.

Would your son like Kefir? It's a great source of probiotics.

Thank you for all your help and advice! I'm going to follow the schedule you recommended. We take a high quality probiotic daily, so I will just add an extra dose during the day, and continue his nighttime dose.
I'm not sure if he would take kefir, but I'm going to try to get some kefir grains. I also make my own yogurt using probiotics, so I'll keep offering him that.

This is a child that does not stop all day and hardly sleeps, so I'll take any extra sleep I can get