New Member with questions.

Where's the rash at? Does she have two rashes by any chance? Did you see a tick? Do you have pets in the house?

Here's length of time treatment is recommended: (I've highlighted for your daughter)


PROPHYLAXIS of high risk groups- education and preventive measures. Antibiotics are not given.

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

EARLY DISSEMINATED: Milder symptoms present for less than one year and not complicated by immune deficiency or prior steroid treatment:
1) Adults: oral therapy until no active disease for 4 to 8 weeks (4-6 months typical) 2) Pregnancy: As in localized disease, but treat throughout pregnancy.
3) Children: Oral therapy with duration based upon clinical response.
PARENTERAL ALTERNATIVES for more ill patients and those unresponsive to or intolerant of oral medications:
1) Adults and children: I.V. therapy until clearly improved, with a 6 week minimum. Follow with oral therapy or IM benzathine penicillin until no active disease for 6-8 weeks. I.V. may have to be resumed if oral or IM therapy fails.
2) Pregnancy: IV then oral therapy as above.

LATE DISSEMINATED: present greater than one year, more severely ill patients, and those with prior significant steroid therapy or any other cause of impaired immunity:
1) Adults and pregnancy: extended I.V. therapy (14 or more weeks), then
oral or IM, if effective, to same endpoint. Combination therapy with at least two dissimilar antibiotics almost always needed.
2) Children: IV therapy for 6 or more weeks, then oral or IM follow up as above. Combination therapy usually needed.

She doesn't need any testing to prove Lyme, as the bulls-eye rash takes care of that. If you wanted to get her tested for other co-infections the tick may have given her, maybe a good idea.

I have no idea how effective amox is against Babesia, ehrlichisis, bartonella, anaplasmosis, etc.

often the ticks give us more than just Lyme alone.

A bullseye rash is diagnostic of lyme disease.


Scheduling an appt with a llmd might be a good idea...and then if she gets symptoms besides the em rash then you won't be waiting....you can always cancel it.

It can take several weeks to get into see one.

You want to do your best to nip this now...and not let it become chronic...when it gets much more complicated.

DonN said...
Where's the rash at? Does she have two rashes by any chance? Did you see a tick? Do you have pets in the house?

Why does it matter where the rash is? and if she has two or one?

The EM is diagnostic for lyme disease...no matter if there are pets in the house or if they saw a tick.

I concur, two symmetrical rashes can be reactions to a number of different pathogens. One bullseye rash is Lyme. Get her to an LLMD. I absolutely love my GP but, he flat out told me "You know more about Lyme disease than I do".

DonN said...
I concur, two symmetrical rashes can be reactions to a number of different pathogens. One bullseye rash is Lyme. Get her to an LLMD. I absolutely love my GP but, he flat out told me "You know more about Lyme disease than I do".

From the J clinic website (FYI):

"It has been noted that unusual, multiple simultaneous EM lesions can occur. Whether this represents a condition compatible with disseminated EM or, perhaps less likely, represents multiple simultaneous Bb bites, is not clear (53). We have had several patients describe and document this feature of the illness. Our record for disseminated Bb target lesions is 50 or so EM lesions noted at one time, reported by a female podiatrist who resides in the countryside just a few miles south of Charlotte, NC."

jemsekspecialty.com/erythema-migrans/

Alright now for another topic... This may make me seem like a hypochondriac but,

Approximately 2 years ago I had a bulls eye rash on my neck. I do frequent the outdoors. This one I remember to be itchy. I was, and always have been asymptomatic for anything I would consider relate-able to Lyme . I rarely get sick as it is. I can recall only one fever and have not taken time off from work in more than 2 years due to illness. I occasionally have allergies. Coincidentally I did have a stiff neck approximately two months ago, I related it to a change in my job where I was required to sit and stare at a computer, and my screen time increased to 10-12 hrs per day, also I purchased a new and noticeably heavier mountain bike helmet. The neck pain was pretty excruciating and I didn't feel like it was quite proportional to the above said changes, but there were no other explanations.

Reading into this for my daughter obviously makes me think. And the statements by Tickbite and others make me worry. Since there was a definitive bulls eye rash then there was an obvious transmittance of a bacteria. Is there anything that can be done this far along? I have Zero symptoms and the rash was 2 years ago, but if it's there my body will have had to build up some antibodies at this point, so far from initial contact? Testing could be indicated and if so is there one that I should target?

I do know that the disease can lay dormant and wait for an opportunity of poor immunity to rear its head. This is why I ask.

Thanks again

Libertee said...

Girlie said...


And, realize if she is tested...it can take several weeks before antibodies will show up.A negative test doesn't mean she doesn't have it.

...and you can't test after to see if she is in remission..... a positive can still show even if she is in remission...and a negative won't mean anything either, really.

Overall, the testing is inaccurate and unreliable....

This, I understand. Though if the second test is positive there may be some satisfaction in knowing what we are dealing with? I understand treating symptoms is important, but what if no symptoms? I mean I feel if we have the means to test, why not test, even with false negatives and positives any information can help the decision making process. If there is a positive it can also help my argument for increasing the length of treatment and dosage of antibiotics.

I do appreciate all responses this far! This community seems extremely helpful and responds very quickly!

The EM warrants treatment. It represents a lyme infection.
But, if testing is helpful to you, no harm done if you're willing to pay. Make sure it is a lab that specializes in tick-borne disease testing....Igenex Lyme WB is $250.

I wouldn't hesitate to make the appt. with a LLMD who treats pediatric patients.

Is her dosage of amoxy in line with the guidelines?

You did see this from the guidelines - it is for an EM rash.

3) Children: oral therapy for 6+ weeks.

The EM warrants treatment. It represents a lyme infection.
But, if testing is helpful to you, no harm done if you're willing to pay. Make sure it is a lab that specializes in tick-borne disease testing....Igenex Lyme WB is $250.

I wouldn't hesitate to make the appt. with a LLMD who treats pediatric patients.

Is her dosage of amoxy in line with the guidelines?

You did see this from the guidelines - it is for an EM rash.

3) Children: oral therapy for 6+ weeks.

Right I understand what You are saying. She is already getting blood testing perhaps the ELISA? I am not sure... I was referring to what the harm in asking for another test two or four weeks from now if the first does not show presence of Lyme.

I hear you guys when you say that the Rash = Lyme, understood. Im not looking for something to say she does not have it. I'm looking for something to say she does, with that I can get more help in my current community while possibly waiting for a LLMD appt.

Honestly, I am not sure what the dosage is for the Amoxy, Since the start we have been a little overwhelmed with information. We were happy to just get the Abx started. I can have a look when I get home from work.

I did see the Guidelines, yes 6+weeks. I don't have control of what was originally prescribed and will ask the MD to lengthen the prescription.

I also posted another thread asking for a LLMD close to Asheville. My email is available in my profile (I think.)

Also I'm not the Mom - I'm a Dad

Libertee said...


Right I understand what You are saying. She is already getting blood testing perhaps the ELISA? I am not sure... I was referring to what the harm in asking for another test two or four weeks from now if the first does not show presence of Lyme.

I hear you guys when you say that the Rash = Lyme, understood. Im not looking for something to say she does not have it. I'm looking for something to say she does, with that I can get more help in my current community while possibly waiting for a LLMD appt.

Honestly, I am not sure what the dosage is for the Amoxy, Since the start we have been a little overwhelmed with information. We were happy to just get the Abx started. I can have a look when I get home from work.

I did see the Guidelines, yes 6+weeks. I don't have control of what was originally prescribed and will ask the MD to lengthen the prescription.

I also posted another thread asking for a LLMD close to Asheville. My email is available in my profile (I think.)

Also I'm not the Mom - I'm a Dad

Yes - no harm in retesting and possibly getting a positive. But try to get the WB IgM and IgG.
Elisa tests have a higher false negative rate.

You’re doing good DAD - sorry if it sounds like I’m jumping all over this - it’s just that we see people who under treat or just let it go and then they’re back here because they are sick. And when it’s children in particular - it is heartbreaking .

I edited my post Libertee (Dad).