Tick Infestation after Camping in the Forest

A 61-year-old male from Nellore, Andhra Pradesh, with a tick at the corner of the eye and back of the ear, a small area of the erythema with a biting tick, and a tick after removal from the patient. The patient presented with a history of traveling and camping for 1 day in nearby Udayagiri Forest, Nellore, with friends. Moreover, 3 days later, he noticed multiple ticks at the corner of his eyelids and the back of his ears. His friends who camped alongside him had no history of similar symptoms. The patient was first evaluated elsewhere locally and received empiric antibiotic doxycycline for 5 days, and visible ticks were removed by the treating physician. A few days later, the patient presented with mild pain, redness, and swelling in the tick bite areas. There was no history of fever, headache, or joint pains, and on physical examination, vitals were stable; no further ticks were found after a thorough examination, and there was no skin rash except for mild redness and swelling at the tick bite area. Based on the patient’s history, presentation, and images of the tick, it is identified as probably a soft tick species bite, as unfortunately, we could not find the tick at presentation to confirm the diagnosis. The patient was treated with a short course of analgesics and was symptom free at a 1-month follow-up. Tick exposure can occur all year-around. Ticks live in grassy, brushy, or wooded areas. Spending time outside camping and gardening could lead to close contact with ticks. The most common symptoms of tick-related illnesses include fever, headache, fatigue, muscle aches, and rash. The major tick-borne diseases in India include Kyasanur forest disease, Crimean–Congo hemorrhagic fever, Lyme disease, Q fever (also known as coxiellosis), and Rickettsial infections. Preventive measures include avoiding wooded and brushy areas with high grass and leaf litter, walking in the center of trails, and checking clothing and body after coming indoors. Treatment includes carefully removing the tick as soon as possible if found attached to the skin and appropriate antibiotic therapy if symptoms like fever or rash develop. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.