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CASE REPORT  
Year : 2016  |  Volume : 9  |  Issue : 3  |  Page : 191-193
Tick bite: Report of a rare case


Department of Dermatology, SVS Medical College, Mahbubnagar, Telangana, India

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Date of Web Publication3-May-2016
 

   Abstract 

Tick bites are uncommon and are vectors of a number of skin diseases; some are innocuous and others deleterious. Herein, we report a case of tick bite in a 50-year-old man who presented with an insect in the abdominal wall, unassociated with systemic involvement. Examination revealed the presence of a tick in the abdominal wall (near the right hypochondrium) with head embedded in it. There is an erythematous, edematous swelling surrounding the bite with elevated skin fold covering the head of the tick. Biopsy from the swelling after the removal of tick revealed foci of fibrinoid material with perivascular lymphocytes, neutrophils, and histiocytes in the dermis.

Keywords: Blood meal, Lyme disease, Rocky Mountain spotted fever, tick, vector

How to cite this article:
Rao AG, Chataraju SD. Tick bite: Report of a rare case. Ann Trop Med Public Health 2016;9:191-3

How to cite this URL:
Rao AG, Chataraju SD. Tick bite: Report of a rare case. Ann Trop Med Public Health [serial online] 2016 [cited 2019 Dec 15];9:191-3. Available from: http://www.atmph.org/text.asp?2016/9/3/191/181663

   Introduction Top


Ticks are small arachnids in the order parasitoformes.[1] Approximately 850 different types of ticks have been enumerated in the literature and are widely distributed throughout the world,[2] are vectors of many diseases. Most ticks do not carry diseases, and most tick bites do not cause serious health problems Ticks dwell and hide in low bush which allows them to physically contact the host.


   Case Report Top


A 50-year-old man came to the department as he noticed the presence of an insect in the abdominal wall. Not associated with pain, burning, fever, or muscle weakness. Examination revealed the presence of a tick in the anterior abdominal wall (near the right hypochondrium) with head embedded in it. Only body and four legs on the right side and two legs on the left side were visualized [Figure 1]. On trying to remove manually, the tick burrowed further leaving behind only the trunk [Figure 2]. There is an erythematous, edematous swelling surrounding the bite with elevated skin fold covering the head of the tick. The tick was removed with forceps, and the bite site was biopsied and sent for histopathological examination which showed foci of fibrinoid material with perivascular lymphocytes, neutrophils, and histiocytes in the dermis [Figure 3].
Figure 1: Tick localized in the anterior abdominal wall with head embedded in it. Only body and four legs on the right side and two legs on the left side are visualized

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Figure 2: Tick burrowed into the skin leaving behind only the trunk

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Figure 3: Microphotograph shows foci of fibrinoid material with perivascular lymphocytes, neutrophils, and histiocytes in the dermis (H and E, ×100)

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   Discussion Top


Tick bites occur most often during early spring to late summer. Usually, one gets tick bite while outdoors. Transmission of the disease depends on the several factors, particularly on the duration of the presence of tick in the host body and on whether the tick is infected or not.[3]

They require a blood meal to grow and survive. Once a tick finds a host such as a human, a pet dog or cat, a deer, or a rabbit it attaches to it and burrows with its mouthparts into the exposed skin. It secretes “cementum” to firmly attach its mouthparts to the skin of the host and secrete saliva containing neurotoxins which prevent the host from feeling the pain and irritation of the bite. Then, it cuts the epidermis and enters it by its hypostome and keep the blood from clotting by excreting anticoagulant.[4] Locally, the tick bite can cause erythema and induration but without pain. Similarly, the index case also did not experience pain despite signs of inflammation. Some people may develop an allergic reaction to a tick bite which may be mild with a few infuriating symptoms. In rare cases, anaphylaxis may occur. Notably, the index case did not exhibit allergic or anaphylactic reaction. Ticks may transmit diseases such as Lyme disease, Rocky Mountain spotted fever, tularemia, ehrlichiosis, relapsing fever, Colorado tick fever, and babesiosis. Systemic involvement has been reported the following tick bite which includes motor paralysis, encephalitis, and persistent atypical lymphocytic hyperplasia [Table 1].[5],[6],[7],[8],[9] However, there is no evidence of systemic involvement in the index case. Treatment consists of removal of the tick with a fine-tipped tweezer and washing the bite site with 70% alcohol, iodine scrub or soap water, and watching for the signs of systemic involvement.
Table 1: Published case reports of systemic involvement in tick bite

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Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Anderson JF. The natural history of ticks. Med Clin North Am 2002;86:205-18.  Back to cited text no. 1
    
2.
Magnarelli LA. Global importance of ticks and associated infectious disease agents. Clin Microbiol News Lett 2009;31:33-7.  Back to cited text no. 2
    
3.
Patey O. Lyme disease: Prophylaxis after tick bite. Med Mal Infect 2007;37:446-55.  Back to cited text no. 3
    
4.
Goddard J. “Tick-borne diseases” Infectious Diseases and Arthropods. 2nd Edition: Springer; Totowa, NewJersey, USA. 2006. p. 8.   Back to cited text no. 4
    
5.
Reusken CJ, Reimerink J, Verduin C, Sabbe L, Cleton N, Koopmans M. Netherlands centre for infectious disease control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands, July and August 2011. Euro Surveill 2011;16:44.  Back to cited text no. 5
    
6.
Nishi M, Matsumoto K, Sawamura M, Nakamura K, Hayashi T, Satoh T, et al. Tick-bite in penile skin: A case report. Hinyokika Kiyo 2010;56:185-7.  Back to cited text no. 6
    
7.
Frimmel S, Löbermann M, Buxton B, Reisinger EC. Abducens nerve palsy following a tick bite: A case report. Int J Med Microbiol 2006;296 Suppl 40:304-5.  Back to cited text no. 7
    
8.
Hwong H, Jones D, Prieto VG, Schulz C, Duvic M. Persistent atypical lymphocytic hyperplasia following tick bite in a child: Report of a case and review of the literature. Pediatr Dermatol 2001;18:481-4.  Back to cited text no. 8
    
9.
Haller JS, Fabara JA. Tick paralysis. Case report with emphasis on neurological toxicity. Am J Dis Child 1972;124:915-7.  Back to cited text no. 9
    

Top
Correspondence Address:
Angoori Gnaneshwar Rao
F12, B8, HIG-2 APHB, Baghlingampally, Hyderabad - 500 044, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.181663

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    Figures

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