Question

A patient removed an attached black-legged tick from the thigh after hiking in a highly endemic area; attachment is estimated at 40 hours and tick was engorged. It is within 48 hours of removal. Best management?

Accepted Answer

Doxycycline 200 mg PO once

Answer

No antibiotics; observe

Answer

Serology now and in 2 weeks; treat if positive

Answer

Amoxicillin 500 mg PO TID for 10 days

Answer

Azithromycin 500 mg PO once

Practice question

A patient removed an attached black-legged tick from the thigh after hiking in a highly endemic area; attachment is estimated at 40 hours and tick was engorged. It is within 48 hours of removal. Best management?