How do I manage tick bites and Lyme borreliosis in pregnant women?

In this report, we present basic data pertinent to the current understanding of borrelial infection in pregnancy, and propose a rationale for the management of Lyme borreliosis in pregnant women. We advocate early detection of attached ticks and their prompt removal. We do not recommend the use of prophylactic antibiotics in pregnant women but support the 'wait and watch' strategy, including early treatment with antibiotics if signs/symptoms of the disease arise. We encourage the approach that antibiotic treatment of pregnant patients is restricted to those having a reliable clinical diagnosis of Lyme borreliosis, and propose intravenous antibiotic treatment with penicillin, or preferably ceftriaxone 2 g daily for 14 days, not only for patients with early disseminated disease but also for those with solitary erythema migrans. Copyright 2009 S. Karger AG, Basel.