What are the implications of a tick bite with a small red rash, specifically a bull's eye (erythema migrans) lesion, around the bite site?

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Differential Diagnosis for Tick Bite with Small Red Rash/Bull's Eye Around Site

  • Single most likely diagnosis
    • Lyme disease: This is the most likely diagnosis due to the characteristic bull's eye rash (erythema migrans) that appears at the site of the tick bite, which is a hallmark symptom of Lyme disease.
  • Other Likely diagnoses
    • Southern tick-associated rash illness (STARI): This condition also presents with a rash similar to erythema migrans, but it is not caused by the bacteria that causes Lyme disease.
    • Tick-borne relapsing fever: Although less common, this disease can cause a rash and is transmitted by ticks, making it a possible diagnosis.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Rocky Mountain spotted fever: This disease is transmitted by ticks and can be fatal if not treated promptly, making it a critical diagnosis not to miss, despite its lower likelihood.
    • Tularemia: Another tick-borne disease that can be severe and even fatal if not treated, thus it should not be overlooked.
  • Rare diagnoses
    • Babesiosis: A rare disease caused by a parasite transmitted by ticks, which can cause a rash among other symptoms, but is less common than other tick-borne illnesses.
    • Ehrlichiosis: A bacterial infection transmitted by ticks that can cause a rash, though it is less frequently associated with a bull's eye rash compared to Lyme disease.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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