Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
For all tick bites, local cleansing and antibiotic cream may be applied. If the
bite area develops itching, preparations containing diphenhydramine (Benadryl)
are recommended. These Benadryl compounds can be applied directly to the skin for
itching or administered orally by tablets. This is usually the only treatment
needed.
However, treatment of the pathogens that the tick may pass to a person depends
on other factors, such as the type of tick, length of time of attachment to the
host, diseases in the community, and symptoms developed by the patient. Specific
treatment is based on the identity of the pathogen transmitted. For example,
oral antibiotics may be prescribed for some diseases. With more significant
symptoms, antibiotics may need to be given intravenously and the patient may
need to be hospitalized. The best approach to treatment is to diagnose which
pathogen has been transmitted to the patient (for example, Borrelia species of
bacteria) and then use the specific treatment to reduce or kill the pathogen.
How is a tick removed from the skin?
The following is a step-by-step method that is suggested for safe and effective
removal of all types of ticks. Web citations 2 and 3 show a diagram of how to
place tweezers to remove a tick.
1. Use a small pair of curved forceps or tweezers. Wear some sort of hand
protection such as gloves so you don't spread pathogens from the tick to your
hands.
2. Using the tweezers, carefully flip the tick over onto its back. Grasp the
tick firmly with the tweezers as close to the skin as possible. Apply gentle
pulling until the tick comes free. Twisting or turning the tick does not make
removal easier because the mouthparts are barbed; in fact, such actions may
break off the head and mouthparts, thereby increasing the chances for infection.
The second Web citation illustrates the proper removal of a tick.
3. Once the tick is removed, don't crush the tick because it may release
pathogens. Rinse it down a sink or flush it down a toilet. Consider keeping it
in a tightly closed jar or taped to a piece of paper. Show the tick to the
doctor if the person bitten become ill after the tick bite.
4. The area of the bite should leave a small crater or indentation where the
head and mouthparts were embedded. If portions of the head or mouthparts remain,
they should be removed by a doctor.
5. After removing the tick, thoroughly cleanse the bite area with soap and
water or a mild disinfectant. Observe the area for several days for development
of a reaction to the bite, such as a rash or signs of infection. Apply
antibiotic cream to the area. Application of an antibiotic to the area may help
prevent a local infection but usually does not affect the chance of developing
diseases transmitted by the tick.
6. Remember to wash your hands thoroughly after handling any tick or
instruments that touched a tick. Clean and disinfect any instruments that were
used.
Other ways to remove ticks, such as using a hot match head or painting the tick
with nail polish, gasoline or other materials, are not advised. Such treatments
can cause the tick to release more fluids back into the bite and increases the
chance to transmit disease before the tick releases itself from the skin.
What is the prognosis (outlook) for people
who get a tick bite?
The great majority of people who get tick bites have no problems during or
after the bite. For people with suppressed immune systems (HIV, cancer,
chemotherapy patients), the prognosis is still good, but they should contact
their physicians and inform them about a tick bite. Also, the faster the tick is
removed after a bite, the less likely the tick will transmit pathogens.
The overall prognosis for an individual person changes if the tick transmits a
pathogen. The prognosis can range from good to poor and is determined by the
disease transmitted, the stage of the disease, and the condition of the patient.
Immune-suppressed patients usually have a worse prognosis than otherwise healthy
people. Consultation with an infectious disease specialist is one of the best
ways to determine the prognosis for the many diseases that ticks can transmit to
people.
The word "rash" means an outbreak of red bumps on the body. The way people use this term, "a rash" can refer to many different skin conditions. The most common of these are scaly patches of skin and red, itchy bumps or patches all over the place.
Bed bugs (from the insect family Cimicidae) are small, reddish-brown tick-like insects that feed by sucking the blood of mammals. They are often found in poorly sanitized areas or in crowded living quarters.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Lyme disease is a bacterial illness, which is spread by ticks when they bite the skin. Initially the disease affects the skin causing a reddish rash associated with flu-like symptoms. It takes weeks to months after the initial redness of the skin for its effects to spread throughout the body. Lyme disease can be treated with antibiotics. Lyme disease can be prevented by using tick avoidance techniques.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Itching can be a common problem. Itches can be localized or generalized. There are many causes of itching to include: infection (jock itch, vaginal itch), disease (hyperthyroidism, liver or kidney), reactions to drugs, and skin infestations (pubic or body lice). Treatment for itching varies depending on the cause of the itch.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
The majority of spiders in the United States are harmless. Two exceptions include the black widow spider and the brown recluse spider. Symptoms of a harmless spider bite generally involve redness, irritation, and pain. alized symptoms of bites from black widow and brown recluse spiders may include: nausea and vomiting, fever, headache, abdominal pain, joint pain, and more. In general, a brown recluse spider bite or black widow spider bite may require medical attention. The information includes pictures of the brown recluse and black widow spiders for identification.
Chiggers are a mite belonging to the Trombiculidae family. Chiggers are most commonly found in grassy fields, gardens, parks, forests, and moist areas around lakes or rivers. Contrary to popular belief, chiggers do not burrow into the skin. Chiggers insert a feeding structure into the skin and inject enzymes that destroy host tissue. The chiggers then feed on this dead tissue. The most common symptom of a chigger bite is itching. Treatment generally includes antihistamines and calamine lotion.
Travelers should prepare for their trip by visiting their physician to get the proper vaccinations and obtain the necessary medication if they have a medical condition or chronic disease. Diseases that travelers may pick up from contaminated water or food, insect or animal bites, or from other people include malaria, meningococcal meningitis, yellow fever, hepatitis A, typhoid fever, polio, and cholera.
Rocky Mountain spotted fever (RMSF) is an infectious disease that's transmitted by the bite of a tick infected with the Rickettsia rickettsii bacterial organism. Initial symptoms of RMSF include fever, nausea, vomiting, muscle pain and severe headache. Later symptoms include rash, abdominal pain, joint pain, and diarrhea. Treatment usually involves a tetracycline antibiotic.
West Nile virus (West Nile encephalitis) is a brain infection caused by a virus. People become infected with the virus after they're bitten by a mosquito that has fed off of a bird that's infected with the West Nile virus. Symptoms in humans include fever, headache, rash, body ache, and swollen lymph nodes.
Bug bites and stings have been known to transmit insect-borne illnesses such as West Nile virus, Rocky Mountain spotted fever, and Lyme disease. Though most reactions to insect bites and stings are mild, some reactions may be life-threatening. Preventing bug bites and stings with insect repellant, wearing the proper protective attire, and not wearing heavily scented perfumes when in grassy, wooded, and brushy areas is key.
Viral hemorrhagic fever(s), or VHFs are a group of illnesses caused by distinct families of viruses. Many of these viruses are life-threatening, and classified as biosafety level four (BSL-4) pathogens. Viral hemorrhagic fever viruses are caused arenaviruses, filoviruses, bunyaviruses, and flaviviruses. The viruses are carried in rodents and transmitted through urine, fecal, saliva, or other body excretions from the infected rodents. Symptoms of viral hemorrhagic fever include marked fatigue, dizziness, muscle aches, loss of strength, fever, and exhaustion. Severely ill patients may also suffer shock coma, seizures, delirium, kidney failure, or nervous system malfunction. There is no established cure for viral hemorrhagic fever.
Tularemia (rabbit fever) is an infection caused by the Francisella tularensis bacteria. People can become infected with tularemia by coming into contact with infected animals or via a tick bite. Symptoms and signs include fever, headache and rash. Tularemia is treated with streptomycin or gentamicin.
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