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Tick Bite

Tick Bite is a topic covered in the 5-Minute Emergency Consult.

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Even in high endemic areas for tick-borne diseases, the risk of infection with a tick-borne pathogen is very low. After a tick bite, patient concerns include:
  • Tick removal
  • Local effect of the bite
  • Possibility of acquiring a tick-borne illness:
    • Fear of contracting Lyme disease
    • Desire to be tested or treated for Lyme


  • Specific tick-borne infections are discussed in other chapters.
  • Tick bite can be from different species of ticks of 2 major types:
    • Soft ticks (Ornithodoros):
      • Cause tick-borne relapsing fever
      • Only feed for minutes and therefore almost never provoke a visit to the ED
    • Hard ticks—especially Ixodes and Dermacentor:
      • Feed for several days to a week and therefore, more likely to be noticed by patient and lead to an ED visit
  • Lyme disease transmission:
    • Species of tick, stage of development, duration of attachment, and geography may all play a role in the possibility of developing Lyme disease.
    • Most cases of Lyme are associated with bites from nymphal Ixodes scapularis ticks.
    • Most cases of Lyme are transmitted only after the tick has been attached for 24–48 hr:
      • Degree of engorgement is a marker for duration of attachment.

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Rosen, Peter, et al., editors. "Tick Bite." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307048/all/Tick_Bite.
Tick Bite. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307048/all/Tick_Bite. Accessed April 26, 2019.
Tick Bite. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307048/all/Tick_Bite
Tick Bite [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 26]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307048/all/Tick_Bite.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Tick Bite ID - 307048 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307048/all/Tick_Bite PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -