Stage 2 (early disseminated): secondary cutaneous annular lesions, fever, adenopathy, central nervous system symptoms cough and pharyngitis may occur Laboratory testing usually not necessary enzyme-linked immunosorbent assay, confirmed by Western blotting polymerase chain reaction of joint fluid may be helpful if available, but culture is difficult and lengthyĬhildren: amoxicillin doxycycline (if older than 12 years)Īdults: doxycycline amoxicillin cefuroxime (Ceftin) or erythromycin (if allergic to penicillin) Stage 1 (early localized): erythema migrans rash at bite of bite, influenza-like symptoms, fever, fatigue, arthralgias, headache, cough, lymphadenopathy
#Tick bite rash skin#
Malaise, myalgias, fever, frontal headache, nausea, vomiting, nonproductive cough, sore throat, pleuritic chest pain, abdominal petechial rash affecting pads and soles of feetĬlinical signs and symptoms skin biopsy of rash with immunofluorescent staining (60 percent sensitive) laboratory testing is of limited usefulness routine findings include thrombocytopenia and hyponatremiaĭoxycycline (Vibramycin) tetracycline chloramphenicol (Chloromycetin) Main reservoirs: rodents, rabbits, and hares
Most cases occur west of the MississippiRiver, especially in mountainous areas. Most cases occur in the northeasternUnited States.įound predominantly in Rocky Mountain region Occurs in rural areas in all states except Hawaii, mostly in south-central and southeastern United States Upper midwestern and northeastern United States Majority of cases are reported in the Northeast and Great Lakes area reported in every state except Montanaīlack-legged or deer tick (I. Limited to Western hemisphere all states except Maine, Hawaii, and Alaskaīlack-legged or deer tick (Ixodes scapularis)
Recommended treatment for suspected tularemia is streptomycin or gentamicin given empirically before evidence of laboratory confirmation. Recommended actions to prevent tick-borne disease include avoidance of tick-infested areas wearing long pants and tucking the pant legs into socks applying N,N-diethyl- m-toluamide (DEET) insect repellents using bed nets when camping and carefully inspecting oneself frequently while in an at-risk area.Īntibiotic prophylaxis is not routinely recommended for a tick bite to prevent Lyme disease unless the risk of infection is high. Treatment with doxycycline (Vibramycin) or tetracycline is recommended for Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, and relapsing fever. Advising patients about prevention of tick bites, especially in the summer months, may help prevent exposure to dangerous vector-borne diseases.Īppropriate antibiotic therapy should be initiated immediately when there is suspicion of Rocky Mountain spotted fever, ehrlichiosis, or relapsing fever rather than waiting for laboratory confirmation. The same tick may harbor different infectious pathogens and transmit several with one bite.
If no symptoms follow exposure to tick bites, empiric treatment is not indicated. In patients with clinical findings suggestive of tick-borne disease, treatment should not be delayed for laboratory confirmation. Treatment with doxycycline or tetracycline is indicated for Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, and relapsing fever. Because 24 to 48 hours of attachment to the host are required for infection to occur, early removal can help prevent disease. Early, accurate diagnosis allows treatment that may help prevent significant morbidity and possible mortality. Various other rashes or skin lesions accompanied by fever and influenza-like illness also may signal the presence of a tick-borne disease. A petechial rash initially affecting the palms and soles of the feet is associated with Rocky Mountain spotted fever, whereas erythema migrans (annular macule with central clearing) is associated with Lyme disease. It is important for family physicians to consider these illnesses when patients present with influenza-like symptoms. Tick-borne diseases in the United States include Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, tularemia, babesiosis, Colorado tick fever, and relapsing fever.