A 36-year-old hiker removed a black-legged tick from his thigh; it was engorged and likely attached for 36 hours in an endemic area. He presents with...

Question

A 36-year-old hiker removed a black-legged tick from his thigh; it was engorged and likely attached for >36 hours in an endemic area. He presents within 24 hours of removal. Best management?

Accepted Answer

Single 200 mg dose of doxycycline within 72 hours of tick removal

Answer

Observe without antibiotics

Answer

Start amoxicillin for 14 days

Answer

Serologic testing now, treat if positive

Answer

Start azithromycin for 5 days

us-abfm MCQ (SBA): Lyme Disease Prophylaxis

A 36-year-old hiker removed a black-legged tick from his thigh; it was engorged and likely attached for >36 hours in an endemic area. He presents within 24 hours of removal. Best management?