How long to treat a subcutaneous tick? - briefly
Remove the subcutaneous tick as soon as possible; if it can be extracted completely, no additional therapy is required. If the tick was attached for > 36 hours or disease risk is high, a 10‑ to 14‑day course of doxycycline is recommended.
How long to treat a subcutaneous tick? - in detail
A tick lodged beneath the skin must be removed promptly. Use fine‑point tweezers or a tick‑removal tool, grasp the mouthparts as close to the skin as possible, and pull upward with steady pressure. Extraction should occur within 24–48 hours of attachment; the longer the parasite remains, the greater the risk of pathogen transmission.
After removal, monitor the bite site and the patient for at least 30 days. Record any emerging signs such as erythema migrans, fever, headache, myalgia, or fatigue. In regions where Lyme‑bearing ticks are common, administer a single prophylactic dose of doxycycline (200 mg for adults, 4.4 mg/kg for children) within 72 hours of removal if the tick has been attached for ≥36 hours and the local infection rate exceeds 20 %.
If clinical manifestations appear, initiate disease‑specific therapy:
- Early localized Lyme disease: doxycycline 100 mg twice daily for 10–21 days (alternatives: amoxicillin or cefuroxime).
- Anaplasmosis: doxycycline 100 mg twice daily for 10 days.
- Babesiosis: atovaquone 750 mg daily plus azithromycin 500 mg on day 1, then 250 mg daily for 7–10 days.
For patients who cannot receive doxycycline, substitute with appropriate macrolide or β‑lactam agents, adjusting dosage for age and renal function.
Follow‑up serology is recommended 2–4 weeks after treatment onset when initial testing was negative but symptoms develop. Extend antimicrobial courses to 4–6 weeks for disseminated or late manifestations, guided by clinical response and laboratory results.
Adherence to the outlined timeline and therapeutic regimens minimizes complications and ensures effective resolution of infections transmitted by a subcutaneously embedded tick.