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Tick bite
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TickChoose one
Bite siteChoose one
Lyme prophylaxisChoose one
Erythema migrans treatmentChoose oneNot in the note with these choices
TestingChoose any
Follow-upChoose one
Follow-up reasonChoose anyJoins the line aboveNot in the note with these choices
Counseling
The risk of Lyme disease after this tick bite is low. Recommended supportive care with an emphasis on washing the bite with soap and water. To prevent bites, use an insect repellent with DEET or picaridin, treat outdoor clothing with permethrin, and check for ticks after outdoor play, especially along the hairline, armpits, and skin folds; remove ticks with fine-tipped tweezers by pulling straight out with steady pressure. Return precautions given including an expanding red rash at the bite or elsewhere over the next month, fever, headache, body aches, joint swelling, drooping of one side of the face, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.
CounselingNot in the note with these choices
Because this was a higher-risk bite, a single dose of Doxycycline was given to lower the chance of Lyme disease. Recommended supportive care with an emphasis on washing the bite with soap and water. To prevent bites, use an insect repellent with DEET or picaridin, treat outdoor clothing with permethrin, and check for ticks after outdoor play. Return precautions given including an expanding red rash over the next month, fever, headache, body aches, joint swelling, drooping of one side of the face, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.
CounselingNot in the note with these choices
This rash is early Lyme disease, and antibiotics treat it well. Take all of the medicine. Recommended supportive care with tylenol or motrin as needed for aches. To prevent future bites, use an insect repellent with DEET or picaridin, treat outdoor clothing with permethrin, and check for ticks after outdoor play. Return precautions given including fever, headache, stiff neck, joint swelling, drooping of one side of the face, fainting, new rashes, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.
What the sources cover
- Tick removed at home or in clinic
- Local reaction vs erythema migrans (size, expansion, no itch)
- Prophylaxis criteria: endemic, Ixodes, > 36 hours, within 72 hours; single dose Doxycycline any age
- Tick testing not recommended
- EM treatment: Doxycycline, Amoxicillin, Cefuroxime; Azithromycin second line
- Monitor for EM and systemic symptoms
- Prevention: repellent, permethrin, tick checks