Cases reported "Pruritus"

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1/3. Multiple pruritic papules from lone star tick larvae bites.

    BACKGROUND: ticks are the second most common vectors of human infectious diseases in the world. In addition to their role as vectors, ticks and their larvae can also produce primary skin manifestations. Infestation by the larvae of ticks is not commonly recognized, with only 3 cases reported in the literature. The presence of multiple lesions and partially burrowed 6-legged tick larvae can present a diagnostic challenge for clinicians. observation: We describe a 51-year-old healthy woman who presented to our clinic with multiple erythematous papules and partially burrowed organisms 5 days after exposure to a wooded area in southern kentucky. She was treated with permethrin cream and the lesions resolved over the following 3 weeks without sequelae. The organism was later identified as the larva of Amblyomma species, the lone star tick. CONCLUSIONS: Multiple pruritic papules can pose a diagnostic challenge. The patient described herein had an unusually large number of pruritic papules as well as tick larvae present on her skin. Recognition of lone star tick larvae as a cause of multiple bites may be helpful in similar cases.
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2/3. Blisters, pruritus, and fever after bites by the Arabian tick ornithodoros (Alectorobius) muesebecki.

    A biologist was bitten by ornithodoros (Alectorobius) muesebecki Hoogstraal, an endemic tick parasite of nesting and resting marine birds on islands in eastern arabia. Irritating bullae developed and for four months he experienced intermittent inflammation and irritation. Two years earlier, after being bitten by the same tick species on a different island, he had experienced only irritation lasting no more than a fortnight. petroleum-industry labourers on another island were admitted to hospital for about two weeks with bullae at numerous bite sites, intense pruritus, headache, and fever. Zirqu virus (bunyaviridae, nairovirus) has been isolated from O. (A.) muesebecki samples from Abu Dhabi. The role of Zirqa virus and/or of salivary toxins in producing irritation and illness, as well as individual sensitivity to the tick and the seasonal dynamics of toxicity or infectivity, should be investigated.
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3/3. Acute urticaria caused by pigeon ticks (argas reflexus).

    A 28-year-old man was admitted to our institute because of acute urticaria appearing a few hours earlier. The patient stated that during sleep he had been bitten by a large number of "insects," which had dropped from wooden ceiling beams under the roof of his room. The patient was living in the center of Milan in a very old house, where numerous pigeons had built their nests under the rooftop. The patient brought along with him some examples of these "insects," which were later classified as pigeon ticks (argas reflexus) (Figs. 1,2). Dermatologic examination revealed the presence of numerous wheals and erythemato-papular lesions on the neck and trunk. These lesions were of different shapes and sizes, bright red in color, and with a small central ulceration corresponding to the tick bite. In addition, there were numerous excoriated lesions due to scratching; the patient in fact complained of very intense pruritus. The general physical examination was within normal limits. Laboratory examinations revealed only slight leukocytosis (9300 WBC/mm3). All other laboratory tests were negative; in particular, the assay for anti-borrelia burgdorferi IgG and IgM was within normal ranges (< 1:256 and < 1:64, respectively). These results were confirmed on subsequent blood samples. Positive radioallergosorbent tests (RAST) to a somatic extract and to the saliva of the tick were observed. A diagnosis of acute urticaria caused by A. reflexus was made. The patient was treated with betamethasone (4 mg intravenously) and chlorpheniramine (10 mg intramuscularly), with resolution of the clinical picture within 3 days.
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