June 22, 2024
Annapolis, US 93 F

Annapolis Bugs and Their Bites: Ticks


As an urgent care here in Annapolis, Evolve Medical Clinics have seen all manner of bug bites. In this public service announcement,  get a quick, down-and-yucky, review of different bugs, what their bites look like and the diseases that they cause.

We begin with ticks but in coming weeks, you can read about spider bites, bed bugs, lice, fleas and chiggers–oh my!


Ticks can cause Lyme disease, southern tick-associated rash illness (STARI), Rocky Mountain spotted fever (RMSF), ehrlichiosis, tularemia and Anaplasmosis.


The initial bite will appear as pictured on the right. The array of rashes caused by ticks depends on the diseases it causes. Please note: remove the tick by grasping at the neck or head (not the body). If the head detaches, the CDC does NOT recommend trying to remove it.


Lyme Disease

The CDC website reports that between 60-80% of those included in its surveillance system report a rash–which means 20-40% never have the rash!

A rash similar to the rash of Lyme disease has been described in humans following bites of the lone star tick, Amblyomma americanum. The rash may be accompanied by fatigue, fever, headache, muscle and joint pains. This condition has been named southern tick-associated rash illness (STARI). The cause of STARI is not known.

Rocky Mountain Spotted Fever

Rocky Mountain spotted fever (RMSF) is a tickborne disease is transmitted to humans by the bite of

American dog tick, Rocky Mountain wood tick, and brown dog tick. Typical symptoms include: fever, headache, abdominal pain, vomiting, and muscle pain. A rash may also develop, but is often absent in the first few days, and in some patients, never develops. Rocky Mountain spotted fever can be a severe or even fatal illness if not treated in the first few days of symptoms.



Unfortunately, the rash of ehrlichia is less specific and can appear much like RMSF. It can also be a whole body redness (called erythroderma) or no rash at all in 40-60% of the cases. As this rash is not specific, we have not included a picture.


Tularemia spreads to humans through insect bites (ticks or deer flys) and direct exposure to an infected animal (rabbits, most often). It is highly contagious and potentially fatal.

Symptoms include a skin ulcer that forms at the site of infection, swollen and painful lymph glands, fever, chills, headache and exhaustion.


Anaplasmosis was previously known as human granulocytic ehrlichiosis (HGE) and has more recently been called human granulocytic anaplasmosis (HGA). Anaplasmosis is transmitted to humans by deer tick bites. Typical symptoms include: fever, headache, chills, and muscle aches. Usually, these symptoms occur within 1-2 weeks of a tick bite. Rash is rarely reported in patients with anaplasmosis and the presence of a rash could mean coinfection Lyme disease or Rocky Mountain Spotted Fever.


Coming Soon: Beg Bugs and Spider Bites!

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