Few things creep me out anymore. But finding a tick embedded in my dermis sets off all kinds of alarm bells. My wife is a master-gardener and our home sits on over a quarter acre lot that she has lovingly and skillfully turned into a show garden. I have no botanical talents but do qualify as unskilled manual laborer. I am enthusiastic and have passable skills in weeding, mowing, spraying, clipping, and raking. I’m always careful to check for ticks after a session of yard work.
Lone star tick embedded four days.
After an especially long and dirty session of winter clean-up in May of this year, I noted itching and irritation under my left lateral malleolus an area I could not visualize. Over a couple of days, this got much worse and I asked another person, who prefers to remain nameless, to look at this area and was told there was a small scab and some redness. After four days I could not wear my left shoe comfortably. I used my iPhone to photograph the area. I perceived the ‘scab” to be an embedded tick feasting on my O positive blood (see photo). I did some deft surgery using a mirror and jeweler’s forceps and removed the tick in one piece.
Since the tick had been embedded for over 100 hours, I was quite concerned about contracting a tick-borne illness. The examined tick had a partial blood meal but was difficult to identify. So, I emailed Deborah A. Hudman, MS, who authored the adjacent article. This is her second manuscript on diseases vectored by Missouri ticks. I also emailed Eden M. Esguerra, MD, our Missouri Medicine Infectious Disease specialist. After this conference of experts, I began doxycycline twice/daily and sent the entire tick to TickReport (www.tickreport.com) for identification and DNA/RNA pathogen testing.
TickReport is a commercial service of the University of Massachusetts’ Laboratory of Medical Zoology. For a fee ranging from a low of $40 to a high of $200 within 72 hours they will: identify tick species and life stage, feeding status, send high resolution photomicrographs, and a report on up to 23 DNA and RNA tests for pathogens. Not being one to scrimp on peace of mind, I parted with $200, not covered by insurance, to hopefully have 23 ‘happy news’ tests in three days. As promised within that time frame, I was emailed a very detailed report finding all 23 DNA/ RNA tests were negative for pathogens, and a very detailed microphotograph of my lately deceased nemesis. It was a ‘partially fed, nymph stage Lone Star Tick.’ With this report in hand, I stopped the antibiotics after four days and felt much relieved. Two weeks later, after another extended garden session in 90-degree weather, I noted a rash on my stomach and legs. Being a physician, and always quick to accept the worst possible outcome, without the TickReport testing I’m sure I would have concluded I had a tick-borne disease. With it I was able to surmise it was a heat rash with some contact dermatitis to the brand-new tick-repellant clothing I was wearing for the first (and last) time.
For physicians’ practices or if you personally become a tick entrée this TickReport service is something to be aware of and consider.