Monday, November 12, 2012

Case of the Week 232

The following 17 mm x 9 mm skin ellipse  was received in the Clinical Parasitology lab for identification. The container was marked "rule out retained tick mouth parts."

On closer examination, the center of the ellipse contained  a dark irregular object:

Through careful dissection, I was finally able to extract the following: 

If you had received a phone call on how to best remove this object, what would have been your advice?


MicrobeMan said...

Photograph four reveals what appears most consistent with mouthparts of a tick; the recurved spines on the hypostome give it away. Also, the basis capituli and parts of the auriculae of the pedipalps appear to be present.

Had I received a call to offer removal advice, I would suggest using a pair of fine-tip tweezers to grasp the tick as close to the skin as possible. Next, I would instruct the caller to pull the tick steadily upward, avoiding twisting or jerking the tick around.

Anonymous said...

I agree, the hypostome with its barbs at reverse angle is consistent with that of a hard tick. We do have the basicapitulus or part of it suggestive of Amblyoma species, however the palpi are missing and the abdomen is also missing this renders further identification impossible.
My identification would be: specimen consistent with hard tick mouth part, unable to further identify due to incomplete body parts.
As for removal, I have been suggested by colleagues to apply a dap of vaseline, the tick will remove the hypostome itself (the vaseline obliterates its spiracles and as the tick cannot breathe, it will be encouraged to fold the barb plates and relocate). Hope this helps.

Florida fan

Anonymous said...

Yes I vote Hard tick mouthparts..

From CDC

Tick Removal
If you find a tick attached to your skin, there's no need to panic. There are several tick removal devices on the market, but a plain set of fine-tipped tweezers will remove a tick quite effectively.
How to remove a tick
1. Use fine-tipped tweezers to grasp the tick as close to the skin's surface as possible.
2. Pull upward with steady, even pressure. Don't twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal.
3. After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.

Avoid folklore remedies such as "painting" the tick with nail polish or petroleum jelly, or using heat to make the tick detach from the skin. Your goal is to remove the tick as quickly as possible--not waiting for it to detach.


Anonymous said...

mouth parts of hard tick . palps missing. hypostome looks like a christmas tree . typical of an Ixodes sp.

Eagleville said...

Best advice, "leave the damn thing alone - you'll do far more damage trying to extract it !"
(Storrs, CT - ground zero for tickborne diseases)

Anonymous said...

Great blog, you should use for some of your images? Here's one of the above in a zoomable viewer.