To treat or not? - Ticks

[hillman1]

I pulled one off about two weeks ago, it was probably on me for about 6-8 hours. It was imbedded in my abdomen, and it was my first tick. It freaked me out and I pulled it out, not saving the tick( I'm in central NY). I went to see my doctor to make certain it was all out, and she prescribed 2 tabs of doxycycline 100 mg one time dose for a prophylactic against any nastiness. She did say that I should have saved the tick to be sent in for examination, but my area has a very low risk for Lyme. No rashes yet, but she said the rash can appear at other areas than the bite site. I'm keeping an eye out for any rashes or symptoms.

 

[daxs]

Most labs will test ticks. So, if you saved it, take it to your doctor when you go for the appointment. Over 50% of people never get the bulls eye rash so lack of the rash does not indicate you do not have Lyme disease

 

[Aviarome]

There are a lot of controversies surrounding the treatment of lyme disease, but I'm a bit surprised that there are as many stories suggesting prophylactic antibiotic therapy.

There have been many studies that suggest that prophylactic antibiotics are not necessary, but there is one study, albeit with some issues and shortcomings, that a one time dose could be useful. However, the general recommendations if the patient is asymptomatic are that prophylactic antibiotics should not be prescribed unless the tick is properly identified as a tick, that it was present for 36-48 hours, the antibiotic can be given in less than 72 hrs, and the antibiotic is not contraindicated.

Careful observation for 4-6 weeks for signs and symptoms is the current recommendation. In high risk areas, such as New England, testing can be utilized as well.

In your specific case, I suppose the argument for antibiotics could go either way. In the end, it seems that everyone errs on the side of caution, and a dose of antibiotics can't hurt, or usually doesn't do any harm.

 

[weatherman]

All right, so... this is driving me just a little crazy. I am a doc and I do primary care (but I don't treat any of you, so please take what I write with a grain of salt). This is what the general recommendations are: (link)

http://www.journals.uchicago.edu/doi/pdf/10.1086/314053?cookieSet=1

Critical factors are type of tick (I'm pretty sure the one in your picture was a deer tick), time of attachment, and (what nobody's mentioned so far) whether you were in a Lyme-endemic area.
(another link)
http://www.aldf.com/usmap.shtml

People are pretty good at telling whether the tick is big or small, I think. So, if it was a small tick, in less than a zillion words, I tell everyone to watch for symptoms. The rash, while not universally there, is there in most (but not all) cases if you watch closely. And it's BIG, like many who have had Lyme here have mentioned. It's not just a little spot. If it's been more than 24 hours that the tick is attached, and they were in CT, RI or SE MA, I tell them there is a very real chance they will need to call me back. If they picked it up in another area, I tell them to worry somewhat less. If the tick was attached <24 hrs, I tell them to worry a lot less.

If there are symptoms, like a rash bigger than a quarter, I go ahead and treat. For a full course. (typically 21 days). 2-3 days of antibiotics has not been proven to help at all. Can it hurt? Sure. You could get an allergic reaction. You could (though the risk is much smaller) contribute to antibiotic-resistant infections in the future.

What does testing the tick do? Well, it tells you whether the tick should have gone to see its doctor for antibiotics. An infected tick does not mean you are infected. That's why they don't recommend it. Plus, it's expensive.

Hope this helps. Back to my alter ego.

Weatherman

 

[cooperhill]

Southern/Seacoast NH Lab test

Most labs will test ticks. So, if you saved it, take it to your doctor when you go for the appointment. Over 50% of people never get the bulls eye rash so lack of the rash does not indicate you do not have Lyme disease

If you're in the Seacoast NH/Durham area, you can bring it to UNH Cooperative Extension Service and they will ID it for you.

UNH Coop

 

[Becca M]

Looks like a deer tick to me! When I was bit by one last year, it hurt like hell for a couple days after I pulled it out, which seemed unusual to me. Regular ticks (I've had plenty!) don't seem to hurt at all within a few minutes of removal. Only a small % of deer ticks carry Lyme disease, from what I researched. Detecting the disease is also not straightforward (again, from my internet searches!) I never got a rash or the flu-like symptoms, so I didn't go to the dr. YMMV - go to the dr if you're nervous!!