Information for Doctors

Australian Spotted Fever - diagnostics and treatment, doctor's algorithms (pdf, 2MB)
Australian Lyme-like Disease - diagnostics and treatment, doctor's algorithms (pdf, 2MB)

Laminated diagnosis and treatment sheets for Lyme Disease and Spotted Fever, designed by members of the TDRU, are also available for doctors by contacting:

Jan Gray (02 9976 9531) at the Health Promotion Unit, Manly Hospital, PO Box 465, Manly NSW 2095.

Australian Spotted Fever (Rickettsia australis)

Diagnosis

Perform diagnostic procedures for Australian Spotted Fever if:

Clinical signs and symptoms of Australian Spotted Fever (fever, headache, sore throat, cough, myalgia, arthralgia, confusion, photophobia, stiff neck, possibly a rash that could be confused with chicken pox), or
Non-allergic illness within 14 days of tick bite, possibly an eschar

Blood sample	Timing	Container	Volume
First	Day of presentation for illness	Citrate (INR) Clotted blood	5 mL 10 mL
Second	14-21 after onset of illness	Citrate (INR) Clotted blood	5 mL 10 mL

Store all serum and culture samples at cool room temperature, out of direct light.

Send as soon as possible after collection, through usual pathology provider, to:

Dr Bernie Hudson, Microbiology Dept, Royal North Shore Hospital, St Leonards, 2065.
Telephone 02 9926 8480; Fax 02 9437 5746

Treatment

If have suspicious signs/symptoms and diagnostic blood samples have been collected

doxycycline 100 mg 12-hourly for 5-7 days (or until have had 3-5 afebrile days).

Diagnosis & Treatment Algorithm

Print version in doctor's algorithms (pdf, 2MB).

Australian Lyme-like Disease (tick-associated borreliosis)

Diagnosis

Perform diagnostics for Lyme-like disease if:

a rash appears after 48 hours or within several weeks of tickbite

If appropriate, please send a skin biopsy for Lyme culture, before giving antibiotics, to:

PaLMS at Royal North Shore Hospital.

For specific instructions about skin biopsy collection and transportation to PaLMS call 02 9926 8480.

Sample type	Container	Volume
Blood sample (initial presentation for illness)	Citrate (INR) Clotted blood	5 mL 10 mL
Skin Biopsy: 4 mm punch biopsy from margin of lesion - divided into 2 portions	Formalin saline in std container Normal saline in sterile tube	- 5-10 mL
Skin Aspirate	Sterile tube	5 mL
Cerebrospinal Fluid	Sterile tube	5-10 mL
Synovial Fluid	Sterile tube Citrrate (INR)	5-10 mL 5 mL

Treatment

Prompt treatment of early suspected Lyme-like disease may prevent chronic debilitating infection.

Initial treatment:

doxycycline 100 mg 12-hourly for 14-28 days
amoxicillin 500 mg 8-hourly for 14-28 days

Pregnant women and children:

amoxicillin is the preferred treatment
paediatric dose is 40 mg/kg/day (in three divided doses)

Diagnosis & Treatment Algorithm

Print version in doctor's algorithms (pdf, 2MB).