How should a tick‑bite site be treated in an adult? - briefly
Remove the attached tick with fine‑point tweezers, grasping as close to the skin as possible, then cleanse the bite site with an antiseptic solution. Observe the area for several weeks for erythema migrans or other symptoms, and give a single 200 mg dose of doxycycline if the tick was attached for more than 36 hours in a Lyme‑endemic region.
How should a tick‑bite site be treated in an adult? - in detail
The bite area should be inspected promptly after removal of the arthropod. Remove any remaining mouthparts with fine‑point tweezers, grasping as close to the skin as possible, and pull straight upward. Disinfect the site with an antiseptic solution such as chlorhexidine or povidone‑iodine. Apply a sterile dressing if bleeding occurs.
Recommended actions:
- Clean the wound thoroughly; avoid rubbing or harsh scrubbing.
- Observe the lesion for erythema, swelling, or a central necrotic area (eschar).
- Record the date of the bite and the estimated duration of attachment; this information guides risk assessment for tick‑borne infections.
- Administer a short course of oral antibiotics (e.g., doxycycline 100 mg twice daily for 10–14 days) if the tick was attached for ≥ 24 hours, the patient presents with fever, rash, or systemic symptoms, or local signs suggest infection.
- Consider prophylactic doxycycline in regions where Lyme disease is endemic and the tick was attached ≥ 36 hours, unless contraindicated.
Monitoring:
- Re‑examine the site within 48–72 hours for progression of erythema, expansion of a target lesion, or development of a bullseye pattern.
- Advise the patient to seek immediate care if fever, chills, headache, myalgia, or joint pain appear, as these may indicate early disseminated infection.
- Document any serologic testing performed for Borrelia, Anaplasma, or other relevant pathogens, and follow local public‑health guidelines for reporting.
Long‑term care:
- Educate the individual on proper tick removal techniques and preventive measures, including use of repellents and protective clothing during outdoor activities.
- Schedule follow‑up visits at 2 weeks and 4 weeks to ensure resolution of symptoms and to address any delayed complications such as post‑treatment Lyme disease syndrome.