How to correctly perform a test for subcutaneous ticks? - briefly
Sterilize a fine‑gauge needle, locate the subdermal tick, and insert the needle at a shallow angle to extract it whole. Transfer the specimen into a labeled ethanol vial for laboratory analysis.
How to correctly perform a test for subcutaneous ticks? - in detail
Detecting ticks lodged beneath the skin requires a systematic approach that combines visual inspection, imaging, and laboratory confirmation. The following protocol outlines each stage in detail.
The practitioner begins by obtaining a thorough patient history, noting recent exposure to tick‑infested environments, onset of localized pain, swelling, or erythema, and any systemic symptoms such as fever or malaise. This information narrows the differential diagnosis and guides subsequent steps.
A careful physical examination follows. The examiner should:
- Inspect the affected area under magnification (10‑20× loupes) to identify any puncture marks, raised nodules, or localized edema.
- Palpate gently to locate firm, mobile masses that may indicate a tick’s body.
- Record the size, depth, and surrounding tissue reaction of each suspected lesion.
If visual cues are insufficient, imaging assists in confirming the presence of a subdermal parasite. Recommended modalities include:
- High‑frequency ultrasonography (10‑15 MHz) to visualize hyperechoic structures with a central anechoic zone, typical of a tick’s abdomen.
- Doppler assessment to detect blood flow within the tick’s feeding apparatus.
- In ambiguous cases, magnetic resonance imaging (T2‑weighted sequences) can delineate the lesion’s exact depth and relation to surrounding structures.
Once imaging confirms a tick, the removal procedure must be performed under sterile conditions:
- Prepare the site with an antiseptic solution (e.g., 2 % chlorhexidine).
- Administer local anesthesia (1 % lidocaine) to the surrounding tissue.
- Use fine‑point forceps or a specialized tick‑extraction instrument to grasp the tick’s mouthparts as close to the skin as possible.
- Apply steady, upward traction without twisting to avoid rupturing the tick’s body.
- Immediately place the extracted specimen in a sealed container with 70 % ethanol for laboratory analysis.
Laboratory confirmation involves:
- Morphological identification under a stereomicroscope, focusing on the tick’s idiosomal features.
- Molecular testing (PCR) for pathogen DNA if the patient exhibits systemic signs, targeting agents such as Borrelia burgdorferi or Rickettsia spp.
Post‑removal care includes:
- Cleaning the wound with sterile saline and applying a topical antibiotic ointment.
- Monitoring for signs of infection or allergic reaction over a 7‑day period.
- Providing the patient with information on tick‑borne disease symptoms and instructions to seek medical attention if systemic manifestations develop.
Adhering to this comprehensive protocol maximizes diagnostic accuracy, ensures complete extraction, and reduces the risk of secondary complications.