Tick Tock
March 13, 2016 11:17 AM Subscribe
Tick bite, probably deer tick, parts left under skin, dark red spot with lighter surrounding circle. Any experience with this?
My daughter had a live tick in her armpit this morning about 3 hours ago that I could not remove without excessive tweezer force leaving at least some piece of the tick under the skin. We've had deer ticks before but this is the first time leaving a piece under the skin. The tick was likely to have attached for less than 24 hours.
The last medical advice we received a year ago for previous incidents was to only go to the doctor if a rash develops. This time may be different because of the increase in Lyme disease locally and the piece left under the skin. I know I could call the nurse hotline or go to the children's express doctor today but I don't have confidence that either is experienced with ticks and infectious disease or would treat it any way other than a splinter. My daughter also happens to be on day 7 of 10 of amoxicillin for an separate issue. We are in western PA where Lyme is prevalent. I personally know of 4 Lyme incidents from last year from close friends.
Any thoughts on this? Any issue with waiting until tomorrow when I can talk to one of the pediatricians or later in the week to see if the piece comes out by itself? I can go back in with a tweezer but this is starting to be traumatic.
Pictures of tick body and bite included!
Bite - The first blurry picture shows the red ring and the second shows the bite marks and barely the black piece left in the skin. The area is much more irritated than past bites that had no mark only tiny, minor irritation from rubbing. This has a half-dime-sized dark red area and seems to be developing a very light red ring around that. The two pictures were about 3 hours after the removal of the tick.
Tick - This tick looks larger than usual - the legs and such clearly visible to the eye though may be female and still a deer tick. What part of the tick is missing - is the head still in the skin or just the mouth?
My daughter had a live tick in her armpit this morning about 3 hours ago that I could not remove without excessive tweezer force leaving at least some piece of the tick under the skin. We've had deer ticks before but this is the first time leaving a piece under the skin. The tick was likely to have attached for less than 24 hours.
The last medical advice we received a year ago for previous incidents was to only go to the doctor if a rash develops. This time may be different because of the increase in Lyme disease locally and the piece left under the skin. I know I could call the nurse hotline or go to the children's express doctor today but I don't have confidence that either is experienced with ticks and infectious disease or would treat it any way other than a splinter. My daughter also happens to be on day 7 of 10 of amoxicillin for an separate issue. We are in western PA where Lyme is prevalent. I personally know of 4 Lyme incidents from last year from close friends.
Any thoughts on this? Any issue with waiting until tomorrow when I can talk to one of the pediatricians or later in the week to see if the piece comes out by itself? I can go back in with a tweezer but this is starting to be traumatic.
Pictures of tick body and bite included!
Bite - The first blurry picture shows the red ring and the second shows the bite marks and barely the black piece left in the skin. The area is much more irritated than past bites that had no mark only tiny, minor irritation from rubbing. This has a half-dime-sized dark red area and seems to be developing a very light red ring around that. The two pictures were about 3 hours after the removal of the tick.
Tick - This tick looks larger than usual - the legs and such clearly visible to the eye though may be female and still a deer tick. What part of the tick is missing - is the head still in the skin or just the mouth?
For future reference, don't tweeze them. Get a cottonball soaked with rubbing alcohol, and douse them in it. They'll nearly always let go.
posted by jferg at 11:28 AM on March 13, 2016 [2 favorites]
posted by jferg at 11:28 AM on March 13, 2016 [2 favorites]
Best answer: The same thing happened to a friend of mine and her doctor advised her to go to an urgent care and get the rest of the tick removed. I think she went on prophylactic antibiotics but I'm not sure. But yeah, I'd head off to the clinic. Better safe than sorry.
posted by cooker girl at 11:33 AM on March 13, 2016 [2 favorites]
posted by cooker girl at 11:33 AM on March 13, 2016 [2 favorites]
Best answer: Looks like the missing part of the tick is the head and mouthparts.
Looks like the rash is the beginning of a classic bullseye rash, which is a sign of Lyme Disease.
Get her to a doctor asap! I have no idea whether the dose of amoxicillin she's already on will be protective (according to the CDC, "Antibiotics commonly used for oral treatment include doxycycline, amoxicillin, or cefuroxime axetil"), but that sounds like a great question for the doctor.
posted by ourobouros at 11:43 AM on March 13, 2016 [4 favorites]
Looks like the rash is the beginning of a classic bullseye rash, which is a sign of Lyme Disease.
Get her to a doctor asap! I have no idea whether the dose of amoxicillin she's already on will be protective (according to the CDC, "Antibiotics commonly used for oral treatment include doxycycline, amoxicillin, or cefuroxime axetil"), but that sounds like a great question for the doctor.
posted by ourobouros at 11:43 AM on March 13, 2016 [4 favorites]
Best answer: Go to the doctor. It's always better to be on the cautious side with Lyme disease because it's so much easier to treat if you catch it early. I have a friend who had undiagnosed Lyme disease for a long time and it's caused her chronic health problems that will probably be lifelong. Not something to risk.
posted by lunasol at 12:01 PM on March 13, 2016 [4 favorites]
posted by lunasol at 12:01 PM on March 13, 2016 [4 favorites]
Best answer: Err on the side of extreme paranoid caution. You should be at the clinic already.
posted by Lyn Never at 12:06 PM on March 13, 2016 [7 favorites]
posted by Lyn Never at 12:06 PM on March 13, 2016 [7 favorites]
Best answer: Never mess around with tick bites; they are completely unlike the majority of bug bites you will encounter (especially if pieces are left in.) As you've seen, at a bare minimum it is a real challenge to get them out cleanly, especially if you don't get much practice. And that kind of thing can easily lead to a plain old infection even if you don't get Lyme.
posted by SMPA at 12:51 PM on March 13, 2016
posted by SMPA at 12:51 PM on March 13, 2016
Best answer: Oh, and the express places I've been to are usually really good with this kind of thing. They're very used to ticks around here, anyway - my guess is that they're always used to ticks in tick country.
posted by SMPA at 12:54 PM on March 13, 2016
posted by SMPA at 12:54 PM on March 13, 2016
Best answer: Go to the doctor and get this treated and documented. Tests for tick borne diseases generally have a high false positive rate and are not sufficient to diagnose an infection absent evidence of a bite and rash.
posted by mikek at 1:42 PM on March 13, 2016
posted by mikek at 1:42 PM on March 13, 2016
Best answer: I'm not a doctor, just a person who has lived in a place with a lot of Lyme disease and read a lot about Lyme disease after getting a suspicious rash at the site of a bite. First of all, it's too early for the bulls-eye rash that can be a symptom of Lyme disease. According to this CDC page, it takes a minimum of 3 days for the rash to develop and 7 days is the average. Whatever redness you see there now is just from the bite.
It's just the mouthparts that are left behind in the skin; that's all a tick sticks into you. From everything I've read, my understanding is that leaving mouthparts behind in the skin does not increase the risk of disease transmission, does not usually lead to infection, and is not really a big deal.
It's too early to test for Lyme disease. It takes a few weeks before enough antibodies develop to give a positive test result, even if you have the disease.
There's very little chance of the tick having transmitted Lyme disease if it was attached for less than 24 hours. It normally takes at least 48 hours.
If I were in your place, I would follow the medical advice you've gotten in the past and do nothing for now. There's very little chance your child has Lyme disease and nothing useful a doctor can do now other than remove the remaining mouthparts (but leaving them in is likely to do no harm.) I see no reason at all why you couldn't wait until later in the week to decide whether to take your child to the doctor.
If you feel swayed by the number of responses urging extreme caution and quick treatment, take 10 minutes to read some of the medical advice easily found online from sources like the CDC and I think you'll end up agreeing that there really is no need to rush off to a doctor right away.
posted by Redstart at 3:43 PM on March 13, 2016
It's just the mouthparts that are left behind in the skin; that's all a tick sticks into you. From everything I've read, my understanding is that leaving mouthparts behind in the skin does not increase the risk of disease transmission, does not usually lead to infection, and is not really a big deal.
It's too early to test for Lyme disease. It takes a few weeks before enough antibodies develop to give a positive test result, even if you have the disease.
There's very little chance of the tick having transmitted Lyme disease if it was attached for less than 24 hours. It normally takes at least 48 hours.
If I were in your place, I would follow the medical advice you've gotten in the past and do nothing for now. There's very little chance your child has Lyme disease and nothing useful a doctor can do now other than remove the remaining mouthparts (but leaving them in is likely to do no harm.) I see no reason at all why you couldn't wait until later in the week to decide whether to take your child to the doctor.
If you feel swayed by the number of responses urging extreme caution and quick treatment, take 10 minutes to read some of the medical advice easily found online from sources like the CDC and I think you'll end up agreeing that there really is no need to rush off to a doctor right away.
posted by Redstart at 3:43 PM on March 13, 2016
Best answer: If you feel swayed by the number of responses urging extreme caution and quick treatment, take 10 minutes to read some of the medical advice easily found online from sources like the CDC and I think you'll end up agreeing that there really is no need to rush off to a doctor right away.
Similar to Redstart, I have spent a lot of time in the tick-infested woods of coastal New England and I am nervous about Lyme. That said, in your shoes I would do the same thing they advise: wait and see. Nothing will be changing. If the bite looks infected, go sooner. Do reasonable things to try to disinfect the wound. Read what the CDC has to say.
posted by jessamyn at 4:44 PM on March 13, 2016
Similar to Redstart, I have spent a lot of time in the tick-infested woods of coastal New England and I am nervous about Lyme. That said, in your shoes I would do the same thing they advise: wait and see. Nothing will be changing. If the bite looks infected, go sooner. Do reasonable things to try to disinfect the wound. Read what the CDC has to say.
posted by jessamyn at 4:44 PM on March 13, 2016
Response by poster: Thank you, strangers, very helpful!
To report back, we did go to the children's express care today. The doctor took 35 minutes to remove the tick head and parts :( thankfully with the aid of a stronger magnifying glass and more importantly the numbing cream. This was the right decision today - the parts were deep and given the existing irritation would have resulted in a visit later in the week with yet more pain and irritation. She said that the amoxycillin was already serving as a prophylactic treatment against disease though she did not actually say that they would have prescribed such a treatment (I wasn't the one there or I would have asked). I was glad to have her taken care of. They did prescribe a mild antibiotic cream given the amount of digging in her little arm.
In my experience, the massive increase in Lyme around here has caused all kinds of inconsistent advice in how to treat and how it presents depending on who you are seeing. The major infectious disease people are literally writing the treatment plans as they go right now as I understand it from people I know who have been seen in these offices locally.
Lastly, I'm not sure I know the right answer but there is much inconsistent advice on how to remove a tick. There is the risk of killing or irritating the tick to the extent that it regurgitates toxins back into the human. This is to be avoided. So I did not use use alcohol, vaseline, heat, cold, or other irritating treatments. I did try a soapy cotton ball but the tick stayed strong. I pulled so hard with the tweezers that the skin was pulled up in the air. In retrospect, the head was definitely going to break so maybe I would have looked for another option at that point and would next time. Based on how far in and how tightly attached, I'm not really sure what I could have done.
Remember to check for ticks and keep the tick treatment nearby! It is so early in the year but this weekend was very warm. We were at fields at the park and on a path through the woods but not off the path in bushes or rolling around.
posted by RoadScholar at 5:22 PM on March 13, 2016 [2 favorites]
To report back, we did go to the children's express care today. The doctor took 35 minutes to remove the tick head and parts :( thankfully with the aid of a stronger magnifying glass and more importantly the numbing cream. This was the right decision today - the parts were deep and given the existing irritation would have resulted in a visit later in the week with yet more pain and irritation. She said that the amoxycillin was already serving as a prophylactic treatment against disease though she did not actually say that they would have prescribed such a treatment (I wasn't the one there or I would have asked). I was glad to have her taken care of. They did prescribe a mild antibiotic cream given the amount of digging in her little arm.
In my experience, the massive increase in Lyme around here has caused all kinds of inconsistent advice in how to treat and how it presents depending on who you are seeing. The major infectious disease people are literally writing the treatment plans as they go right now as I understand it from people I know who have been seen in these offices locally.
Lastly, I'm not sure I know the right answer but there is much inconsistent advice on how to remove a tick. There is the risk of killing or irritating the tick to the extent that it regurgitates toxins back into the human. This is to be avoided. So I did not use use alcohol, vaseline, heat, cold, or other irritating treatments. I did try a soapy cotton ball but the tick stayed strong. I pulled so hard with the tweezers that the skin was pulled up in the air. In retrospect, the head was definitely going to break so maybe I would have looked for another option at that point and would next time. Based on how far in and how tightly attached, I'm not really sure what I could have done.
Remember to check for ticks and keep the tick treatment nearby! It is so early in the year but this weekend was very warm. We were at fields at the park and on a path through the woods but not off the path in bushes or rolling around.
posted by RoadScholar at 5:22 PM on March 13, 2016 [2 favorites]
Response by poster: Oh, and the doctor said it was her third yet most tenacious tick (part) of the day.
posted by RoadScholar at 5:25 PM on March 13, 2016
posted by RoadScholar at 5:25 PM on March 13, 2016
The reason ticks are so difficult to remove is because they're in skin like corkscrews. Something that allows you to pull and twist at the same time, like this, can increase the chances of getting more out.
I live near Lyme Ground Zero, have had it, know plenty of others who have -- and I have to nth Redstart. What often makes Lyme difficult to deal with is that the "classic" symptoms aren't always present, and/or can resemble other illnesses. Early detection can be key to avoiding complications. If it's on your radar already as a very small possibility, you're in very good shape.
posted by gnomeloaf at 6:51 PM on March 13, 2016
I live near Lyme Ground Zero, have had it, know plenty of others who have -- and I have to nth Redstart. What often makes Lyme difficult to deal with is that the "classic" symptoms aren't always present, and/or can resemble other illnesses. Early detection can be key to avoiding complications. If it's on your radar already as a very small possibility, you're in very good shape.
posted by gnomeloaf at 6:51 PM on March 13, 2016
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Sorry I can't speak to more about the tick itself. We've had lots of Lyme scares and several prophylactic courses of antibiotics for ticks left in more than 24 hours in Lyme-heavy areas. I would also call the regular pediatrician to just discuss how that would work with the antibiotics she's already taking.
posted by flourpot at 11:27 AM on March 13, 2016 [1 favorite]