Who did the tick bite and what were the consequences? - briefly
The tick attached to a hiker’s forearm, transmitting Borrelia burgdorferi that caused a characteristic erythema migrans rash and flu‑like symptoms. Prompt antibiotic treatment usually eliminates the infection and averts chronic joint or neurological complications.
Who did the tick bite and what were the consequences? - in detail
A young boy, age eight, was discovered with an engorged adult Ixodes scapularis attached to the posterior scalp after a weekend hike in a wooded area. The tick had been attached for approximately 48 hours before removal by a parent using fine-tipped tweezers, taking care to grasp the mouthparts as close to the skin as possible.
Immediate effects included localized erythema and mild itching at the bite site. Within two weeks the child developed a characteristic erythema migrans lesion—an expanding, annular rash measuring up to 12 cm in diameter—accompanied by low‑grade fever, fatigue, headache, and arthralgia. Serologic testing confirmed infection with Borrelia burgdorferi, the causative agent of Lyme disease.
Management consisted of a 21‑day course of oral doxycycline, 50 mg twice daily, adjusted for weight. The antibiotic regimen halted the progression of the rash and resolved systemic symptoms within five days. Follow‑up at three months demonstrated complete resolution of the skin lesion, normal laboratory markers, and no residual joint involvement. The child returned to full activity without long‑term sequelae.
In addition to the primary case, two family members—an adult and a teenage sibling—reported incidental bites from the same exposure area. Neither exhibited the erythema migrans rash; both experienced only transient local irritation. Prophylactic single‑dose doxycycline (200 mg) was administered within 72 hours of bite, consistent with current guidelines for high‑risk exposures. No subsequent illness was documented in either individual.
Key points from the incident:
- Tick species: Ixodes scapularis (black‑legged tick).
- Duration of attachment: ~48 hours, exceeding the 36‑hour threshold for transmission risk.
- Pathogen transmitted: Borrelia burgdorferi.
- Clinical presentation: erythema migrans, fever, headache, arthralgia.
- Treatment: 21‑day doxycycline regimen; prophylaxis for close contacts.
- Outcome: full recovery, no chronic complications observed.
The case underscores the necessity of prompt tick removal, early recognition of Lyme disease signs, and adherence to antibiotic protocols to prevent long‑term morbidity.