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How Was This Month's Case Treated?
Tick Removal
Written by Pedro M. Barros, MD, Pedro Hispano Hospital, Oporto, Portugal. Edited by Michael P. Kelly, CPT.

Photo by Pedro M. Barros, MD, Pedro Hispano Hospital, Oporto, Portugal.
 
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July 2011 Blink

A 73-year-old male presented to our emergency department with an ab­normal mass on his inferior left eyelid. The lesion had been growing over the last four days. On direct observation, the diagnosis was obvious and unusual: A tick was attached to the eyelid. Ticks are a known vector for numerous diseases, the most common being Lyme disease. Studies have shown that the risk of disease transmission increas­es significantly after 24 hours of attachment and is even higher after more than 48 hours. In this case, the patient had no signs of local or systemic infection.

It is important to remove the tick completely, including the mouthpart and the cement the tick has secreted to secure attachment. Improper tick removal may cause mouthparts to break off in the skin, possibly leading to infection or granuloma formation. We used blunt forceps and perpendicular traction, grasping the tick as close to the skin as possible and being careful not to twist the head. Afterward, an antiseptic solution was applied to the attachment site, and the patient was in­formed about signs and symptoms of local and systemic illness. No antibiotic prophylaxis was prescribed.

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