Ixodes tick infestation presenting as preseptal cellulitis: A rare occurrence

Abstract

Herein, we report a case of preseptal cellulitis due to an Ixodes tick infestation, which was subsequently treated by mechanical removal and antibiotics. A 50-year-old man presented to the ophthalmology clinic with gradually increasing swelling of both upper and lower lids of his right eye with associated watering. He was diagnosed with unilateral preseptal cellulitis with a grayish nodule near the lower eyelid, which was found to be a hard tick of the Ixodes genus. Complete removal of the tick with the help of a blunt forceps under local anesthetic cover was performed. A prophylactic course of oral antibiotics was also prescribed to the patient. After a period of 1 week, all his symptoms had subsided without any systemic manifestations. Ticks are acarine ectoparasitic hematophagies, many species of which have been recognized as vectors of lethal pathogens. Tick infestation of the ocular tissue is a rare occurrence. Complete removal of the tick parts is pertinent to prevent the late sequelae and serious complications. This case report suggests that clinicians should be aware about tick bite–related sequelae, such as preseptal cellulitis and other complications, to reach an early diagnosis.