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Tick bites and skin rashes

Elston, Dirk M

Current Opinion in Infectious Diseases:
doi: 10.1097/QCO.0b013e328335b09b
Skin and soft tissue infections: Edited by Roderick J. Hay

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.

Author Information

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:

© 2010 Lippincott Williams & Wilkins, Inc.