From the Guidelines
If you have a tick bite without a bullseye rash but are experiencing body aches and chills, you should seek medical attention promptly and consider a single dose of oral doxycycline within 72 hours of tick removal as the preferred antibiotic regimen for chemoprophylaxis of Lyme disease, as recommended by the Infectious Diseases Society of America (IDSA) 1. The recommended dose is 200 mg for adults and 4.4 mg/kg (up to a maximum dose of 200 mg) for children. This approach is based on the latest clinical practice guidelines, which emphasize the importance of prompt treatment to prevent the progression of Lyme disease and other tick-borne illnesses. Some key points to consider include:
- Removing any attached tick properly using fine-tipped tweezers, grasping close to the skin and pulling upward with steady pressure.
- Cleaning the bite area with rubbing alcohol or soap and water.
- Documenting when the tick bite occurred and when symptoms began, as this information helps your healthcare provider with diagnosis.
- Being aware that fever, chills, fatigue, body aches, headache, and swollen lymph nodes are common early symptoms that warrant medical evaluation. It's also important to note that while doxycycline is the preferred treatment, alternatives such as amoxicillin may be considered for individuals who cannot take doxycycline, such as pregnant women or children under 8 years old 1. However, the most recent and highest quality evidence supports the use of a single dose of doxycycline as the primary approach for chemoprophylaxis of Lyme disease following a high-risk tick bite 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Tick Bite Treatment without Bullseye Rash
- Patients presenting with flulike symptoms, such as body aches and chills, after a tick bite should be suspected of having a tickborne disease 2.
- The location of exposure, identification of the specific tick vector, and evaluation of rash (if present) can help identify the specific disease 2.
- Lyme disease, Rocky Mountain spotted fever (RMSF), ehrlichiosis, anaplasmosis, babesiosis, tularemia, Colorado tick fever, and tickborne relapsing fever are some of the tickborne diseases that can affect patients in the United States 2.
Treatment Options
- Prompt antimicrobial therapy using oral agents such as doxycycline or amoxicillin is successful in more than 90% of patients with Lyme disease 3.
- Doxycycline or amoxicillin can be used as treatment for Lyme disease, while cefuroxime axetil or erythromycin can be used as an alternative 4.
- Single-dose doxycycline (200 mg orally) can be used as prophylaxis in selected patients within 72 hours of tick removal 4, 5.
Prophylaxis and Prevention
- Prophylactic treatment after tick exposure in patients without symptoms is generally not recommended but may be considered within 72 hours of tick removal in specific patients at high risk of Lyme disease 2, 5.
- Counseling patients on the use of protective clothing and tick repellents during outdoor activities can help minimize the risk of infection 2.
- Routine antibiotic prophylaxis is not justified after a tick bite, even in an endemic area, as the risk of infection is low 6.