What does an infectiologist do after a tick bite? - briefly
The specialist inspects the bite, reviews the exposure timeline, and estimates the probability of infection with tick‑borne pathogens. Based on this risk assessment, they may start prophylactic therapy, order diagnostic tests, and provide instructions for monitoring symptoms.
What does an infectiologist do after a tick bite? - in detail
A tick attachment prompts an infectious‑disease specialist to begin with a focused interview. The clinician records the bite’s date, exact site, duration of attachment, and any removal method used. Identification of the tick species and life stage follows, because vector competence varies among Ixodes, Dermacentor, and other genera.
Next, a physical examination targets the bite area and the entire skin surface. The practitioner looks for a characteristic expanding red rash, tenderness, or regional lymphadenopathy. Absence of a rash does not exclude early infection; therefore, systemic signs such as fever, headache, myalgia, or arthralgia are also noted.
Risk assessment incorporates geographic exposure, season, and known prevalence of tick‑borne pathogens in the region. Patient factors—age, pregnancy status, immunosuppression, or allergy to antibiotics—modify the risk calculation.
If the tick was attached for ≥36 hours in an area where Borrelia burgdorferi transmission is documented, and the patient has no contraindications, the specialist may prescribe a single dose of doxycycline (200 mg for adults, weight‑adjusted for children) as prophylaxis. Alternative regimens are selected for patients with doxycycline intolerance or for pathogens not covered by doxycycline (e.g., Anaplasma spp., Babesia spp.).
Laboratory testing is ordered when clinical suspicion persists or when prophylaxis is not indicated. The protocol includes:
- Enzyme‑linked immunosorbent assay (ELISA) for Lyme disease antibodies, followed by Western blot confirmation if positive.
- Polymerase chain reaction (PCR) assays for Anaplasma phagocytophilum, Ehrlichia chaffeensis, or Babesia microti when specific symptoms arise.
- Complete blood count and liver function tests to detect hematologic or hepatic involvement.
Patient instruction emphasizes:
- Proper tick removal with fine‑point tweezers, pulling upward without twisting.
- Daily inspection of the bite site for rash development.
- Immediate reporting of fever, joint pain, or neurological symptoms.
- Scheduling a follow‑up visit within 2–4 weeks to reassess and interpret test results.
All findings, decisions, and patient communications are documented in the medical record, and, where required, cases are reported to public health authorities for surveillance and outbreak control.