What does a tick bite look like?
As you can see on the picture, most patients come with at least the top of his head still stuck in the skin.
It is not always possible to say the exact kind of tick
Quickcare or ER?
I see tick bites in the clinic setting as well as the ER. It is a good idea to see a health care provider soon to remove the tick and prescribe antibiotics.
Ticks carry bugs. Their bite may pass along those bugs.
Also, most patients kind of freak out seeing an insect squirming inside their skin.
Red Flags that will send you to the ER right away:
What will your doctor ask?
Your doctor will want to know your symptoms. Remember, a symptom is your description of your condition to your doctor. It is your story.
Answering the following questions will help your doctor understand:
- How long have you had the tick?
- Do you have any associated muscle pain? Fever? Redness?
- Is there any pus?
- Do you have any rashes?
- Are you getting any chills?
What will your doctor look for?
Upon examination, a doctor will look for signs of infection such as fever, swelling, and redness.
Your doctor will look for a rash. Specifically, Erythema Migrans which is described as painful and/or itchy. This Lyme disease rash is red and circular with a clear area on the inside. Hence the common name of “target lesion” or “Bull’s Eye.” Typically, this rash develops 1-2 weeks after the bite.
A rash seen with Rocky Mountain Spotted Fever begins starts on the extremities (arms and legs) and moves to the chest.
What is your doctor thinking?With an embedded tick, the doctor is thinking of preventing infection.
This means taking out the tick and covering with antibiotics.
Your doctor will want to prevent tick-borne illnesses such as Lyme Disease, Rocky Mountain Spotted Fever, Ehrlichiosis or Colorado Tick Fever.
At the initial bite, it not possible to know if or what kind of illness will follow a tick bite. That is why antibiotics are started
What are some tick bite treatments?
The tick needs to come out. Period.
I cut out the ticks in the following manner:
- First I clean the area up with Betadine.
- Then I inject (yes, I give a shot) around and under the skin with an anesthetic such as lidocaine.
- I gently pull on the tick while I detach the tick using a scalpel. Traction will help prevent squeezing the neurotoxins into the patient.
- Then, I cover the area with a topical antibiotic.
Afterward, I send my patients home with a prescription of an antibiotic such as doxycycline (100 mg twice a day for a week) or amoxicillin for children.
How long will you be sick?
The recovery from cutting out the tick will generally last 2-3 days. There usually is a little swelling.
As mentioned, antibiotics such as doxycycline will be given for 14 days if erythema migrans developed. However, if the bite has occurred within 72 hours and there are no symptoms, an easy preventative treatment is one dose of Doxycycline 200mg. For children or pregnant women, Amoxicillin is a good alternative.
I have my patients get rechecked 2-3 after the tick removal.
Please keep in mind. Long term illnesses due to Lyme disease include meningitis, arthritis, and carditis.
One prevention is to spray your clothes with DEET or permethrin before going off into the woods.
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Let me tell you a story
Ahh, Fresh country air. Away from the Silicon Valley and into the woods. A chance to see what California was like before the Spaniards arrived in the 1700s. He had read of our history from his library in Bangalore. Now he can see it first hand.
This outing is the ideal trip for the over wired. No specialty coffees. No smartphones. No headsets.
Although the mighty Grizzly bears are long gone, there are still some elements of nature that survived the Spanish conquest. Connecting with nature by having a tick stuck on his skin was not Kumar’s plan.
In Kumar’s case, he had the tick for one day. There was no fever, swelling, or pus associated.
I was able to remove it easily using local anesthesia. He was given a one-time oral dose of Doxycycline.
Being the perfect little techie, he took his medication after scrutinizing its shape and expiration date. He was back at his cubicle without missing a text message.
I hope this helps.
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