Multiple bites from the larvae of the tick Ixodes ricinus. A case report

The case is presented of a 32-year-old man with multiple reddish-blue papules on both thighs and sporadic on the lower part of the trunk and lower legs, clinically compatible with multiple 'insect' bites. The lesions were found to be multiple bites from larvae of the tick Ixodes ricinus. The larvae are about 1 mm long, live very close to the ground, and mainly parasitize small rodents. They are, therefore, generally not well known. Although seldom encountered, we suggest that bites from the larvae of the tick Ixodes ricinus should be kept in mind in patients with multiple 'insect' bites, especially in periods with high tick activity. The differential diagnosis is important because the larvae may cause infection with the spirochete Borrelia burgdorgferi.