Cellulitis, headache, and fever following tick bites.

摘要

A 53-year-old male resident of rural Kentucky presented to his primary care physician with a 2-day history of severe headache and fever to 104degF. Symptoms had developed 5 days following his removal of numerous ticks from his lower extremities. One tick was embedded and may not have been completely removed, leading to an area of redness on the left ankle that expanded over the ensuing days, eventually forming an abscess and cellulitis. Despite treatment with oral doxycycline, his symptoms worsened, and on the 8th day of illness, with erythema extending to the thigh, he was admitted to the hospital. The initial working diagnosis was probable staphylococ-cal cellulitis and sepsis, for which the patient was treated with vancomycin, clindamycin, and continuation of oral doxycycline.