Tick bites and skin rashesElston, Dirk MCurrent Opinion in Infectious Diseases: April 2010 - Volume 23 - Issue 2 - p 132–138 doi: 10.1097/QCO.0b013e328335b09b Skin and soft tissue infections: Edited by Roderick J. Hay Abstract Author Information Purpose of review Fever and a rash following a tick bite can signify a true medical emergency. Ticks are important vectors of disease worldwide, including Rocky Mountain spotted fever, Lyme disease, and Congo-Crimean hemorrhagic fever. This paper will review the major ticks of medical importance and the diseases they transmit, including important emerging pathogens. Recent findings Rocky Mountain spotted fever continues to be the most lethal tick-borne illness in the United States and is emerging as an important disease in South America. Other important emerging diseases include human anaplasmosis, southern tick associated rash illness, human monocytic ehrlichiosis, and a variety of rickettsial fevers including those caused by Rickettsia parkeri and Rickettsia amblyommii. Summary Most tick-borne illnesses respond readily to doxycycline therapy. In the case of Rocky Mountain spotted fever, therapy should be started when the disease is suspected and should never be delayed for confirmatory tests. Accurate identification of tick vectors can help establish a diagnosis and can help guide preventive measures to reduce the burden of disease. Department of Dermatology, Geisinger Medical Center, 100 North Academy Ave, Danville, Pennsylvania, USA Correspondence to Dirk M. Elston, MD, Director, Department of Dermatology, Geisinger Medical Center, 100 North Academy Ave, Danville, PA 17821, USA Tel: +1 570 271 8050; fax: +1 570 271 5940; e-mail: Dmelston@geisinger.edu © 2010 Lippincott Williams & Wilkins, Inc.