Tick Bites and Tickborne Illness

Presentation

The patient arrives with a tick attached to the skin ( Fig. 182.1 ) and is often frightened or disgusted and concerned about developing Lyme disease, Rocky Mountain spotted fever (RMSF), or “tick fever.” Alternatively, the patient may only have a history of having removed a tick within the past week or so and now has developed a spreading erythematous rash at the previous site of attachment ( Fig. 182.2 ). By this time, systemic signs and symptoms consisting of myalgia, arthralgia, fever, headache, and fatigue may be present.