MANUAL MINORS
Tick bites occur when these parasites attach to the skin to feed on blood. Ticks can transmit diseases such as Lyme disease, Rocky Mountain spotted fever, and ehrlichiosis. Tick bites are often painless and go unnoticed, but they may cause localised redness, itching, and swelling. The risk of disease transmission increases if the tick remains attached for several hours.
Diagnosis
Diagnosis is based on identifying the tick bite, often with the tick still attached to the skin. If the tick has already detached, a red, inflamed lesion may be observed. For bites complicated by tick-borne diseases, symptoms such as fever, muscle pain, rash, or fatigue may indicate conditions like Lyme disease (with its characteristic “erythema migrans” bullseye rash).
Differential Diagnosis
Condition | Key Difference |
|---|---|
Insect bite | May cause itching or local swelling but does not remain attached to the skin. |
Folliculitis | Inflammation of a hair follicle causing redness and pain, unrelated to bites. |
Contact dermatitis | Rash caused by irritants or allergens, without a history of a bite. |
Skin infection | Swelling, redness, and warmth without prior bite history. |
Emergency Management
In the emergency department, the tick should be removed as soon as possible using fine-tipped tweezers, gripping it as close to the skin as possible and pulling with steady, even pressure, avoiding crushing the tick. It is important not to use substances like alcohol or heat to detach it, as this can increase the risk of disease transmission.
After removal, the area should be cleaned with soap and water, and an antiseptic may be applied. The patient should be educated to monitor for signs of infection or systemic symptoms suggesting tick-borne diseases.
Definitive Treatment
If the patient shows signs of infection or is at risk of disease transmission (e.g., the tick has been attached for more than 36 hours in areas where Lyme disease is prevalent), prophylactic antibiotics, typically a single dose of doxycycline, may be administered.
For cases where a tick-borne illness has already developed, treatment should be adjusted to the specific disease, with antibiotics such as doxycycline, amoxicillin, or cefuroxime, depending on the clinical presentation. Close follow-up is important to detect long-term complications such as Lyme arthritis or Rocky Mountain spotted fever.
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