Tick Bite Granuloma After Incomplete Removal of Ixodes ricinus Tick

Ixodes ricinus (Acari: Ixodidae) ticks infest humans in Europe most frequently. This report describes an interesting case of a persistent inflammatory skin reaction developed in a patient after the incomplete removal of an I. ricinus female tick. A 47-year-old female patient incompletely removed a female I. ricinus tick feeding in the lumbar region for approximately 12 h. After 9 weeks of persistent itching and burning, the skin from the tick feeding site was sampled for histopathological examination. The lesion exhibited the presence of abundant inflammatory infiltrates composed of lymphocytes, plasma cells, and eosinophils, as well as multinucleated macrophages and irregular fibrosis. The histopathological image revealed the presence of a tick bite granuloma. This study indicates that persistent symptoms of an inflammatory reaction may develop after incomplete tick removal, even after a short time of feeding.