Pedemy All toolsPick the picture and get the next step, weight-based doses, tests and when to admit.
This tool gives the next step for a child with a tick-borne illness other than Lyme disease. It follows the AAP Red Book 2024–2027 and CDC clinician guidance, with the IDSA 2020 guideline for babesiosis.
For fever after possible tick exposure it screens red flags, then starts doxycycline 2.2 mg/kg (max 100 mg) twice daily at any age without waiting for tests, with the duration rules for spotted fever, ehrlichiosis and anaplasmosis, the supportive labs and how to use PCR and paired serology.
Separate paths cover tularemia (gentamicin for severe disease, ciprofloxacin or doxycycline for mild), babesiosis (atovaquone plus azithromycin, clindamycin plus quinine, exchange transfusion), tick-borne relapsing fever, Powassan virus and alpha-gal syndrome. Lyme disease and tick bite prophylaxis point to the Lyme tool.
Yes. CDC and the AAP recommend doxycycline at any age for suspected rickettsial disease. Short courses do not stain permanent teeth, and delay in treatment is the main cause of death.
2.2 mg/kg per dose twice daily, maximum 100 mg per dose; children 45 kg or more take 100 mg twice daily. Continue until at least 3 days after the fever resolves, usually 5–7 days in total; anaplasmosis 10–14 days.
No. Early serology is often negative and PCR can miss Rocky Mountain spotted fever. Start doxycycline on clinical suspicion and confirm later with paired IgG serology 2–10 weeks apart.
Atovaquone 20 mg/kg (max 750 mg) twice daily plus azithromycin 10 mg/kg on day 1 then 5 mg/kg daily for 7–10 days. Severe disease uses IV azithromycin or clindamycin plus quinine, and sometimes red cell exchange.
Severe disease: gentamicin IV or IM for 10 days. Mild disease: oral ciprofloxacin 15 mg/kg twice daily for 10 days, or doxycycline for 14–21 days.
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