My mom had a tick bite last year. She developed a circular rash and fever in late June 2009. Doctor suspected ehrlichiosis, prescribed 30-day doxycycline. After just a few days doxycycline treatment, she does not have any symptom. Then in October, she did a lyme test again although she does not have any symptom by that time, but that came back positive.
She got another tick bite again this year, I think we discovered and got the tick off early- within a day or so. Her blood test after a month and half is: LYME IGM positive 23KD IGM BD Reactive 39K IGM BD Reactive 41KD IGM BD Reactive
Lyme disease screen 2.05 (last year was > 5) Index valu 0.00-0.90
I was told by the doctor that she has positive lym, it is an indication of recent infection. He prescribed a 21-day doxy again. My mom took the doxycycline for about a week, the first 3-4 days she took it in the US before she went back to China. And after continuously taking it for one day in China. She developped a kind of very itchy spotty red rash, symmetrically along the side part of the arms and legs until feet. She had a full course (28 days) doxycycline last year in the US with no problem, and even this time, the first 3-4 days in the US were no reaction. Because we are afraid of allergic reaction to the doxy, she stopped the doxy. She went to a doctor in China, who does not think it is an allergic reaction to the doxy, and gave her some non-antibiotics prescription that seems to help the rash to go away.
Now we are debating whether she need another full course of antibiotics. I was told by some doctor that since she had tick bite last year and developed symptom that time, she probably had lyme that time and then her lyme test will remain positive for maybe years, and IgM is notariously being sticky. That doctor said we should see if she has any symptom, otherwise don't even do the lyme test.
So far my mom does't see any obvious symptom from this year's bite. Any suggestion on what to do?
Thank you.
Posted by jackie81 (Member # 27031) on :
If it were me I would continue taking the antibiotics just to be safe. It is not worth it in my opinion to wait for sympotms.
its great that you are so concerned about your mom!
Posted by kimmie (Member # 25547) on :
treat aggressively to avoid the situation that we are in now.
Posted by bcb1200 (Member # 25745) on :
Most disseminated cases are positive IgM, Negative IgG. I was like this.
Posted by joy4ever (Member # 28384) on :
Is oral amoxicillin as effective as doxy? Since My mom has some unknown rash to doxy, I am not sure whether we should continue to finish that doxy.
Posted by janet thomas (Member # 7122) on :
PENICILLINS are bactericidal. As would be expected in managing an infection with a gram negative organism such as Bb, amoxicillin has been shown to be more effective than oral penicillin V. With cell wall agents such as the penicillins, kill kinetics indicate that sustained bactericidal levels are needed for 72 hours to be effective. Thus the goal is to try to achieve sustained blood and tissue levels. However, since blood levels are extremely variable among patients, peak and trough levels should be measured (for details, refer to the antibiotic dosage table). Because of its short half-life and need for high levels, amoxicillin is usually administered along with probenecid. An extended release formulation of amoxicillin+clavulanate (``Augmentin XR'') may also be considered if adequate trough levels are difficult to attain. An attractive alternative is benzathine penicillin (``Bicillin-LA''- see below). This is an intramuscular depot injection, and although doses are relatively small, the sustained blood and tissue levels are what make this preparation so effective.