Due to the nonspecific nature of tick-related illness, combined with decreased body awareness, tick bites and their associated symptoms can often be less conspicuous in children, and easier to overlook or attribute to an alternative diagnosis. This is important to remember, especially with rickettsial disease, because while children represent 6% of all reported cases of RMSF, they account for 22% of fatalities.98 Children’s style of play (outdoors, with pets, etc.) may place them at increased risk for tick exposure. Because of this, familiarity with the pathophysiology of tick-borne disease is essential to making an accurate diagnosis and treatment plan. Preferred pediatric treatment regimens for Lyme disease include doxycycline, amoxicillin, or cefuroxime. Doxycycline is especially indicated if neurological symptoms are present. The preferred agent for treatment of RMSF, ehrlichiosis, and anaplasmosis in pediatric patients is also doxycycline. As with pregnancy, the adverse effects of doxycycline in children (in particular, teeth staining) have been largely disproved in recent studies.99,100
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References
Excerpted from: Chao C, Decker KW. Tick-borne illness: a diagnostic approach for the Urgent Care clinician. Evidence-Based Urgent Care. 2023 June;2(6):1-30. Reprinted with permission of EB Medicine. Learn more about Evidence-Based Urgent Care and get a free sample issue at https://www.ebmedicine.net/urgent-care-info