Conjunctival attachment of a live tick (Ixodes species) in an infant: a rare case report with literature review

Abstract

Introduction: The attachment of the tick to the conjunctiva of the host is a very rare entity. This study aims to report a rare case of a tick attached to the conjunctiva of a 10-month-old male infant. Case presentation: A 10-month-old infant presented to the emergency department brought in by his parents with right eye redness for the past 8 hours owing to the attachment of an unknown foreign body to the conjunctiva. General clinical examination revealed that the child was conscious and alert; redness of the right eye was visible. Under an ophthalmic microscope, the foreign body was found to be a tick. The tick was gently removed with a sterilized blunt forceps. Seven days follow-up revealed no ophthalmic or systemic complications. Clinical discussion: The infestation of ticks to the ocular tissues is considered a very rare entity in the literature, and the major manifestations are vasculitis, uveitis, keratitis, and conjunctivitis. In addition, sometimes the infestation may appear as an eyelid margin tumor when the tick embeds in the meibomian gland orifice. Conclusion: Conjunctival tick attachment presenting with the symptoms of eye redness and itching is an uncommon entity. The proper management is the complete removal of the tick using a blunt, medium-tip, angled forceps.

Tick Infestation on the Scalp Leading to Misguided Medical Consultation: A Case Report

“…Their bites possess sufficient strength to pierce the skin of both animals and humans, potentially transmitting various infectious agents such as viruses, bacteria, and protozoa. Only a couple of species, Argasidae (soft ticks) and Ixodidae (hard ticks) are recognized for directly facilitating the transmission of pathogens to humans [1]. Hard ticks are more prevalent and pose a higher risk of disease transmission with the more challenging removal procedure [6,7].…”

“…Hard ticks are more prevalent and pose a higher risk of disease transmission with the more challenging removal procedure [6,7]. Environmental factors influencing the development and distribution of ticks encompass favorable conditions for reproduction, spanning regions with diverse climates, high humidity, and the presence of livestock [1]. The duration of tick attachment varies from 1 to 10 days, with symptoms emerging between 1 and 14 days after the presumed tick bite [4].…”

“…The authors reported that the patient had no direct contact with domestic animals. The tick may have been transmitted from the parents, who lived in a rural area and owned livestock [1].…”

“…The Ixodidae family is characterized by a rigid and sclerotized dorsal plate, known as hard ticks. Conversely, the Argasidae family lacks a rigid dorsal plate and is known as soft ticks [1,2]. Ticks are equipped with specialized mouthparts containing sharpened chelicerae, which can penetrate the host's skin during feeding.…”

“…They frequently target wild, hairy mammals and can cause diverse complications when biting humans, including skin granulomas, erythema chronicum-like lesions, and skin abscess formation. Moreover, ticks secrete saliva containing anti-coagulants and antiinflammatory proteins, posing a risk of transmitting pathogenic diseases like Crimean-Congo hemorrhagic fever, Lyme disease, and tularemia [1,3,4]. Notably, the emerging concept of scalp eschar and neck lymphadenopathy (SENLAT) after tick bite enhances understanding of tick-related health issues.…”