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HWN Suggests

Tick-Borne Illnesses: Identification and Management in the Emergency Department

The symptoms of tick-borne illnesses are often nonspecific and are easily misdiagnosed early in the course of illness. Emergency clinicians, particularly those in endemic areas, need to maintain a high level of suspicion to correctly identify, diagnose, and treat patients with suspected tick-borne illnesses. Clinical characteristics can vary greatly between the 9 tickborne illnesses discussed in this review; however, most of these illnesses will present with a fever and rash. The diagnosis of many tick-borne illnesses can be time-consuming. Treatment is often based on clinical characteristic and clinical suspicion, as many confirmatory tests take days to weeks to result. The recommendations…

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 Emerging Tick-Borne Illnesses: Not Just Lyme Disease Part 1

Tick-borne disease surveillance studies have shown increasing prevalence, transmission, and disease burden over the last decade. Tick-borne illnesses remain a public health threat and the true incidence remains unknown and is thought to be underrepresented. Although Lyme Disease is the most frequently reported tick-borne disease in the United States, the incidence of four other tick-borne diseases is noted to be increasing in the United States:

 Tick-borne Illness in the ED: Part I

The recommended treatment regimen depends on the disease stage and patient characteristics... Early Localized or Disseminated Lyme Disease Without Neurological or Cardiac Involvement - Oral doxycycline (100 mg BID), amoxicillin (500 mg TID), or cefuroxime axetil (500 mg BID) for 14 days are considered the first-line treatment choices. Doxycycline is often used in non-pregnant patients older than 8 years of age, as it covers anaplasmosis and other rickettsial diseases that may co-infect or be confused with early manifestations of Lyme disease. Amoxicillin is recommended for pregnant patients or children younger than 8 years old. Cefuroxime can be used in pencillin-allergic patients.

 When It Comes to Ticks, It’s Okay to Make RASH Decisions

There are many different tick-borne diseases and one tick can carry (and transmit) multiple diseases at once. Providers should have a high suspicion for co-infection, especially if patients are sicker than expected or if they are not improving after several days of treatment.

Articles of Interest

Caring for Patients after a Tick Bite

Proph... Children weighing less than 45 kg Doxycycline 4.4 mg/kg orally 200 mg Once

New Tricks for Removing Ticks & Avoiding RMSF & Lyme Disease

Many of us feel it’s best to inject Lidocaine under the tick using a small bore insulin style syringe/needle, then pull it out.

POTD: Tick Bites

The prophylaxis is a single dose of 200mg doxycycline, or 4mg/kg up to a max of 200mg for children. Antibiotic treatment following a tick bite is not recommended as a means to prevent anaplasmosis, babesiosis, ehrlichiosis, Rocky Mountain spotted fever, or other rickettsial diseases. Rather, patients should be warned and be vigilant against symptoms such as fever, rash, or other symptoms concerning for these diseases.