Ewww … a tick!
Lyme disease is endemic to Pennsylvania, affecting 50,000 to 70,000 people per year in the commonwealth. Still, most people think it will never affect them. Then one morning you look in the mirror, and there is a tiny black dot on your neck. As you inspect closer, you realize it’s a tick. What do you do?
Lyme disease is typically carried by the deer tick (Ixodes scapularis). Peak time of infection occurs from May to August. Symptoms and length of duration of infection determine disease management. There are three different stages.
1. Early local infection (7-14 days): the classic bullseye rash often accompanied by viral symptoms (fever, joint pains, headache).
2. Early systemic infection (days to weeks): Areas of involvement can include the skin (multiple rashes), nervous system (tingling and numbness into arms or legs), heart (heart rhythm disturbances) and/or eyes (irritation).
3. Late systemic infection (months to years): Both joints and nervous system (fatigue, alterations to brain structure/function) can be affected.
If the tick was attached for less than 36 hours, removal is adequate without medication, but the patient should monitor for rash or viral symptoms and present to medical personnel if concerns arise.
The most common form of removal for a tick is to use fine-tipped tweezers, grip as close to the skin as possible, and pull with upward steady pressure. There is a user-friendly “Tick Bite Bot” on the CDC website with guidance on effective removal techniques.
If the tick is engorged and/or there is concern about attachment of greater than 36 hours, a one-time dose of the antibiotic doxycycline is recommended. Doxycycline is used in both pediatric and adult patients for prophylaxis and treatment of Lyme disease. This one-time dose should be given within 72 hours of tick removal.
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If the tick was attached longer (more than 72 hours) or any of the above symptoms as listed in the three stages of Lyme disease are present, your healthcare provider may order a blood test to determine if you have Lyme disease and possibly start you on the antibiotic doxycycline for a longer period. Such treatment courses range from 10 to 28 days depending on severity of symptoms at time of presentation, and you may require close follow-up to ensure symptom resolution.
Kristin Juhasz, D.O., is an Emergency Medicine Core Faculty member at UPMC Hamot.
This article originally appeared on Erie Times-News: Kristin Juhasz, D.O.: What to do if you find a tick on your body