Instructor
Elizabeth Maloney, MD
Education Co-Director, VectorWise CME
Description
Reports of known blacklegged tick bites appear to be a source of confusion for some clinicians. Only 20% or so of all patients with Lyme disease were aware of the bite that caused their infection. When a tick bite history is present, it is crucial to consider the bite in the broader clinical context. This activity will help physicians distinguish between symptomatic and asymptomatic blacklegged tick bites.
Learning objectives:
- Distinguish between asymptomatic and symptomatic blacklegged tick bites
- Employ general management principles for asymptomatic and symptomatic blacklegged tick bites
Accreditation Statement
This session, When a Blacklegged Tick Bite Is More Than a Bite, is approved for 0.25 enduring AAFP Prescribed credit.
The AAFP has reviewed VectorWise CME, and deemed it acceptable for AAFP credit. Term of approval is from 05/15/2025 to 05/14/2026. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
AAFP Prescribed credit is accepted by the American Medical Association as equivalent to AMA PRA Category 1 credit(s)™ toward the AMA Physician’s Recognition Award. When applying for the AMA PRA, Prescribed credit earned must be reported as Prescribed, not as Category 1.
Evidence-based bibliography for further study
• Steere AC, Sikand VK. The Presenting Manifestations of Lyme Disease and the Outcomes of Treatment. N Engl J Med 2003; 348:2472-2474.
• Steere AC, Dhar A, Hernandez J, Fischer PA, Sikand VK, Schoen RT, et al. Systemic Symptoms without Erythema Migrans as the Presenting Picture of Early Lyme Disease. Am J Med 2003;114:58-62.
• Smith RP, Schoen RT, Rahn DW, et al. Clinical characteristics and treatment outcome of early Lyme disease in patients with microbiologically confirmed erythema migrans. Ann Intern Med. 2002 Mar 19;136(6):421-428.
• Tibbles CD, Edlow JA. Does this patient have erythema migrans? JAMA. 2007 Jun 20;297(23):2617-27.
• Magid D, Schwartz B, Craft J, Schwartz JS. Prevention of Lyme disease after tick bites. A cost-effectiveness analysis. N Engl J Med. 1992 Aug 20;327(8):534-41.
• Cameron D, Maloney E, Johnson L Evidence assessment and guideline recommendations in Lyme disease: the clinical management of known tick bites, erythema migrans rashes and persistent disease. Expert Rev Anti Infect Ther 2014 Sep; 12(9): 1103-1135.
• Piesman J, Hojgaard A. Protective value of prophylactic antibiotic treatment of tick bite for Lyme disease prevention: an animal model. Ticks Tick Borne Dis. 2012 Jun;3(3):193- 196.
• Wormser GP, Dattwyler RJ, Shapiro ED et al. The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 2006; 43(9):1089-1134.
About the Instructor
Elizabeth L. Maloney, MD
Education Co-Director, VectorWise CME; Partnership for Tick-borne Diseases Education
Dr. Maloney is a Minnesota family physician whose current focus is on tick-borne diseases education and policy. She began providing comprehensive, evidence-based, continuing medical education courses for physicians in 2007 and subsequently founded Partnership for Tick-borne Diseases Education, a non-profit providing evidence-based continuing medical education programming and materials on tick borne diseases. She has authored several peer-reviewed papers and treatment guidelines on Lyme disease and is currently a member of the federally mandated Tick-Borne Diseases Working Group (TBDWG). She is currently the Education Co-director at VectorWise CME.