What disease is associated with subcutaneous ticks? - briefly
Lyme disease, caused by the bacterium Borrelia burgdorferi and transmitted by Ixodes ticks, is the primary illness linked to subcutaneous tick infestations.
What disease is associated with subcutaneous ticks? - in detail
The disease most frequently linked to ticks that become lodged beneath the skin is Lyme borreliosis, caused by the spirochete Borrelia burgdorferi and related species. When a tick penetrates the dermis and remains subcutaneously, it can maintain prolonged contact with the host’s blood supply, increasing the likelihood of pathogen transmission.
Pathogen and vector
- Borrelia species reside in the midgut of hard‑tick genera such as Ixodes scapularis (eastern United States) and Ixodes ricinus (Europe).
- Subcutaneous placement occurs when the tick’s mouthparts embed deeply, sometimes after the tick is removed from the surface and later found in the tissue.
Clinical phases
- Early localized stage (3–30 days)
- Erythema migrans: expanding erythematous rash, often annular with central clearing.
- Flu‑like symptoms: fever, headache, myalgia, fatigue.
- Early disseminated stage (weeks to months)
- Multiple erythema migrans lesions.
- Neurological involvement: meningitis, facial nerve palsy, radiculitis.
- Cardiac manifestation: atrioventricular block, myopericarditis.
- Late disseminated stage (months to years)
- Arthritis of large joints, especially the knee.
- Chronic neuroborreliosis: peripheral neuropathy, encephalopathy.
Diagnostic considerations
- Serologic testing (ELISA followed by Western blot) detects specific IgM and IgG antibodies.
- Polymerase chain reaction (PCR) on skin biopsy or synovial fluid confirms presence of Borrelia DNA.
- In cases of subcutaneous tick remnants, histopathology may reveal inflammatory infiltrates and spirochetes within the dermis.
Therapeutic regimen
- Doxycycline 100 mg orally twice daily for 14–21 days (first‑line for adults).
- Amoxicillin or cefuroxime for patients unable to tolerate doxycycline, especially children under 8 years.
- Intravenous ceftriaxone for severe neurological or cardiac involvement, administered for 14–28 days.
Epidemiology and risk factors
- Endemic regions: northeastern United States, mid‑Atlantic Europe, parts of Asia.
- Outdoor activities in wooded or grassy habitats raise exposure probability.
- Improper removal of attached ticks, leading to retained mouthparts, heightens subcutaneous colonization risk.
Prevention
- Use of permethrin‑treated clothing and DEET‑based repellents.
- Prompt, complete removal of attached ticks with fine‑point tweezers, ensuring the head and mouthparts are extracted.
- Regular skin inspection after outdoor exposure to detect and eliminate ticks before deep embedding occurs.
The association between subcutaneous ticks and Lyme disease underscores the importance of meticulous tick removal and early medical evaluation when skin lesions or systemic symptoms appear following a bite.