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My daughter had this. It's very dangerous, you need at least 30 days doxycycline. What state: type of hospital was he treated in? What level do you mean by not well? I think I wd suggest you have your primary doctor call ilads.org for guidance, or even in this extreme case the CDC which I wd normally never recommend for Lyme

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He is on doxy. Went to emergency room last week and an infectious disease doc diagnosed him fairly quickly. Has follow up appts end of this week. He finally has his energy back, but he had bilirubin in his liver, malaise, massive migraine for 7 days, no appetite. What is standard long term treatment?

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Doxy is treatment of choice. My son had anaplasma and ehrlichia and Lyme. The anaplasma and ehrlichia were found first. My son was not hospitalized. He had these infections and we were not aware. He was young and the illness was attributed to something else. Not everyone who gets anaplasma gets so sick they need hospitalization. My LLMD says he never sees a case of anaplasma and ehrlichia where the patient does not have Lyme. Need to follow up on Lyme and other coinfections when he gets out of the hospital.

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In NH there should be plenty of good tick borne disease specialists. I would recommend contacting ILADS.org for guidance, list of doctors and medical guidance for your doctor. Normally I would not say to call the CDC in any circumstance, however because anaplasmosis is at least recognized by the CDC as something very serious you may want to consider giving them a call to ask for guidance. Since you have an acute case at the moment which they seem to believe in they may be able to give some guidance. If it were me I would want at least 30-60 days of Doxy and then would need to figure out what else is going on. My DD had 5 or 6 tick borne infections, it's never just one.

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