Red flags & when to go in person for Lyme Disease (Early) - Triage

Audience: pediatric

Lyme disease is an infection often passed by tick bites, especially in children who play outdoors. Early signs can include a rash that looks like a bull's-eye, fever, tiredness, and muscle aches. It's important to watch for these symptoms and get medical advice quickly. Telemedicine can help you understand symptoms and decide if your child needs to see a doctor in person. However, some signs mean your child should get in-person care right away, like difficulty breathing, severe headaches, or weakness. Early treatment usually works well, but delays can cause more serious problems. This guide helps families know when to use telemedicine and when to seek urgent medical care for early Lyme disease in children.

Red flags — go in person / ER

• Difficulty breathing or swallowing — go to emergency care immediately.
• Severe headache with neck stiffness — seek urgent medical evaluation.
• Weakness, numbness, or paralysis in any part of the body — get emergency care without delay.

What telemedicine can do

• Initial symptom assessment for mild rash or fever.
• Guidance on tick bite exposure and prevention.
• Advice on when to seek in-person care or testing.
• Follow-up questions after starting treatment for early Lyme disease.

What telemedicine cannot do

• Emergency symptoms like difficulty breathing or paralysis.
• Severe neurological symptoms needing physical examination.
• Administering intravenous antibiotics or urgent imaging.
• Diagnosing complicated or late-stage Lyme disease requiring specialist care.

What is Early Lyme Disease?

Early Lyme disease happens after a tick bite when bacteria enter the body. It often causes a red rash that may look like a bull's-eye, fever, chills, headache, and feeling tired. These symptoms usually appear within 3 to 30 days after the bite.

Common Early Symptoms in Children

Children may have:

Not all children get the rash, so other symptoms are important to notice.

When to Use Telemedicine for Lyme Disease

Telemedicine can help if your child has mild symptoms or if you are unsure about a rash or tick exposure. A healthcare provider can evaluate symptoms, review history, and guide next steps. They can also advise if testing or antibiotics are needed.

Red Flags That Need In-Person Care Immediately

Seek urgent medical care if your child has:

These signs may indicate serious complications that require emergency treatment.

Preparing for a Telemedicine Visit

Before the visit:

After the Telemedicine Visit

Follow the healthcare provider's instructions carefully. This may include:

How to prepare for your tele-visit

• Observe and note the time symptoms began.
• Take clear photos of any rash or skin changes.
• List recent outdoor activities and possible tick exposures.
• Prepare a list of current medications and allergies.
• Ensure a quiet place with good internet or phone connection for the visit.

After your tele-visit

• Follow prescribed medication schedule exactly.
• Watch for any worsening or new symptoms.
• Keep scheduled follow-up appointments.
• Contact healthcare provider if red flags appear.
• Maintain good hydration and rest during recovery.

FAQs

Can Lyme disease be diagnosed through a telemedicine visit?

Telemedicine can help healthcare providers assess symptoms and history, but diagnosing Lyme disease often requires a physical exam and sometimes lab tests. If needed, the provider will advise you to get in-person evaluation or testing.

What should I do if my child has a tick bite but no symptoms?

If your child has a tick bite but no symptoms, monitor the bite area for rash or signs of infection. Remove the tick carefully if still attached. Contact a healthcare provider if symptoms develop or if you are unsure about the tick removal.

Is the bull's-eye rash always present in Lyme disease?

No, the bull's-eye rash (erythema migrans) appears in many but not all cases of Lyme disease. Some children may have other types of rashes or no rash at all, so other symptoms like fever and fatigue are important to watch for.

How soon should treatment start after a tick bite?

Treatment is usually started when symptoms of Lyme disease appear or if a healthcare provider confirms the diagnosis. Early treatment is important to prevent complications. Do not start antibiotics without medical advice.

Can telemedicine replace all in-person visits for Lyme disease?

Telemedicine is useful for initial assessments and follow-up but cannot replace all in-person visits, especially if your child has severe or emergency symptoms. Physical exams and lab tests often require in-person care.

Sources

1. Lyme Disease — Centers for Disease Control and Prevention (CDC).
2. Lyme Disease — MedlinePlus, U.S. National Library of Medicine.
3. Lyme Disease — Mayo Clinic.
4. Lyme Disease: Clinical Features and Diagnosis — National Library of Medicine.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child has emergency symptoms or worsening condition, seek immediate medical attention.