Bacteria, viruses, and parasites can get transmitted to the human body through a tick bite. Most common tick-borne disease in U.S is Lyme disease. Almost 80 percent of Lyme disease cases present with Erythema migrans rash. The first line of treatment for children and adults is Doxycycline. Rocky Mountain spotted fever can prove fatal if not treated promptly. The disease presents as a sudden onset of fever and headache. Doxycycline is the treatment of choice. 
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Image: “EMT/Nursing Pediatric Emergency Simulation – April 2013 1” by COD Newsroom. License: CC BY 2.0

Tick-borne diseases are transferred to humans as a result of the tick bite. Ticks can be infected with parasites, viruses, or bacteria.

Common Tick-borne Diseases

  • Lyme disease (most common in U.S)
  • Human Monocytic Ehrlichiosis
  • Human Granulocytic Ehrlichiosis
  • Tularemia
  • Rocky Mountain spotted fever

Rare Tick-borne diseases

  • Anaplasmosis
  • Colorado tick fever
  • Tick-Borne Relapsing Fever
  • Q fever
  • Babesiosis
  • Southern Tick-Associated Rash Illness
  • Powassan encephalitis


  • Tick checks at night in endemic areas
  • Long clothing
  • Socks over pants
  • Use of insect repellent (Composition: 20 percent DEET, or Picaridin)
  • Anti-tick dog collars
  • Use of pre-treated clothing which repels ticks
  • Avoiding areas with leaf litter
  • Avoiding high grass places

Finding Ticks

  • Take a bath as soon as you come indoors. It helps getting rid of ticks that are still crawling on the body.
  • After coming back from tick-infested areas, one should check full body to find areas of tick bites. Parents should do this for their children.
  • Carefully examine pets and clothing for

Lyme Disease

It is a tick-borne disease that is caused by the transmission of Borrelia burgdorferi through the bite of infected ticks. Early signs and symptoms appear 3 to 30 days after the bite of a tick. Late symptoms present after days to months.

Early signs and symptoms

  • Fever
  • Chills
  • Headache
  • Fatigue
  • Joint aches
  • Myalgia
  • Swollen lymph nodes
  • Lymphadenopathy
  • Erythema migrans rash: This rash is seen in about 80 percent of the infected individuals. It appears at the site of tick bite in average 7 days and gradually expands to an area of 12 inches or more. It appears as a bull eye and is rarely painful or itchy

Later signs and symptoms

  • Severe headaches
  • Neck stiffness
  • Erythema migrans rash on areas other than that of tick
  • Arthritis particularly involving large joints.
  • Facial palsy
  • Intermittent pain (bones, muscles, and joints)
  • Lyme carditis (irregular heartbeats)
  • Dizziness episodes
  • Shortness of breath
  • Meningitis
  • Neuropathy
  • Tingling, numbness, or shooting pains in hands and feet
  • Problems related to short-term memory


  • Blood titers with confirmatory Western Blot test
  • During the early phase of the disease, blood titers may give false negative results.
  • Rule of 7:
  • A headache for 7 days
  • 7th nerve palsy (Bell’s palsy)
  • 70 percent monocytes on CSF


Early lime disease:

Adults: Doxycycline 100mg b.d (10-21 days)


Amoxicillin 500mg t.i.d (2-3 weeks)

Children: Doxycycline 4 mg/kg per day

Ceftriaxone is used for Lyme meningitis and other neurological manifestations.

Late Lyme Disease:

Adults: Doxycyclin 100mg b.d (28 days)

Children: Doxycycline 4 mg/kg per day

Late Lyme disease with neurological manifestations:

Adult patient: IV ceftriaxone – 2 to 4 weeks

Rocky Mountain Spotted Fever

It is a disease caused by bacterium Rickettsia rickettsii as a result of the tick bite. It can even prove to be fatal in the absence of appropriate management. The disease presents itself as a sudden onset of fever and headache. Common signs and symptoms are as follows:

  • Sudden onset of fever
  • The petechial rash starts on hands and feet and spread inward. It occurs 2-5 days after fever and presents in up to 90% of the cases.
  • Red eyes
  • Nausea
  • Vomiting
  • Myalgia
  • Thrombosis
  • DIC
  • Frontal headache
  • Abdominal pain
  • Loss of appetite


Diagnosis is made on the basis of clinical presentation and symptoms of the patient. It is later confirmed through specialized lab tests.


The first line treatment for adults and children is doxycycline. It is given until the patient is afebrile for 3 days.


There are at least three different ehrlichial species in the United States that cause Human ehrlichiosis:

  • Ehrlichia chaffeensis
  • Ehrlichia ewingii
  • Ehrlichia muris-like


Typically symptoms appear within 1 -2 weeks after the tick bite.

  • Fever
  • Headache
  • Fatigue
  • Muscle aches


Diagnosis is made by clinical presentation and symptoms of the patient. It is later confirmed through lab tests.

The gold standard serologic test for Ehrlichiosis is indirect immunofluorescence assay.


The first line of treatment for adults and children of all ages is doxycycline.

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