What is done in a hospital after a tick bite? - briefly
Patients receive a clinical assessment, sterile tick removal, and evaluation for tick‑borne infections; prophylactic antibiotics are given when indicated, and follow‑up monitoring instructions are provided.
What is done in a hospital after a tick bite? - in detail
A patient who arrives at a medical facility after a tick attachment undergoes a systematic evaluation. The initial step is a thorough physical examination focused on the bite site and surrounding skin. Clinicians assess for signs of redness, swelling, ulceration, or a central erythema ± central clearing that may indicate early infection. The tick, if still attached, is removed with fine‑pointed tweezers, grasping the mouthparts as close to the skin as possible and pulling straight upward without crushing the body. After removal, the bite area is cleaned with antiseptic solution and a sterile dressing is applied.
Laboratory investigations are ordered based on epidemiological risk and clinical presentation. A complete blood count may reveal leukocytosis in systemic infection. Serologic testing for Borrelia burgdorferi is considered when the bite occurred in a Lyme‑endemic region and the patient presents with erythema migrans or other early symptoms. Additional serologies for Anaplasma, Ehrlichia, or tick‑borne encephalitis virus are requested when relevant exposure history exists.
Pharmacologic prophylaxis follows established guidelines. Single‑dose doxycycline (200 mg) is administered within 72 hours of bite for individuals at high risk of Lyme disease, unless contraindicated. In cases of suspected or confirmed anaplasmosis or ehrlichiosis, a full 7‑10‑day doxycycline course is prescribed. When the tick is identified as a carrier of Rickettsia spp., appropriate tetracycline therapy is initiated. For patients with known allergy to doxycycline, alternative agents such as azithromycin may be used.
If the tick is identified as a potential vector for rabies, post‑exposure prophylaxis is initiated according to national protocols, including administration of human rabies immune globulin and a series of rabies vaccine doses.
Observation includes monitoring for fever, headache, arthralgia, or neurological deficits. Patients are instructed to report any new symptoms promptly. Follow‑up appointments are scheduled to reassess the bite site, review laboratory results, and adjust treatment if necessary. Educational material is provided, outlining tick‑avoidance strategies, proper removal techniques, and signs of early infection to enhance self‑care after discharge.