Tick Paralysis: A Thorough Examination May Prevent Unnecessary Harm

Abstract

Tick paralysis is a relatively uncommon tick-borne illness that is often overlooked and misdiagnosed. Therefore, it is not unusual for cases to undergo unnecessary work-up and interventions that may delay correct diagnosis and treatment, placing the patient at risk for catastrophic consequences. We present the case of a four-year-old female who developed ascending flaccid paralysis, initially misdiagnosed with Guillain-Barré syndrome (GBS). She was placed in the pediatric intensive care unit (PICU) for mechanical ventilation after failing to respond to intravenous immunoglobulin (IVIG) administration and plasmapheresis. Later in her hospital course, she was correctly diagnosed to have tick paralysis.

Keywords: dermacentor variabilis; guillain-barré syndrome; intravenous immunoglobulin; tick paralysis; ticks.

Figure 1. (A) Female American dog tick, Dermacentor variabilis. (B) Female Rocky Mountain Wood tick, Dermacentor andersoni.

The images were acquired from the CDC Public Health Image Library (PHIL) are in the public domain and thus are free of any copyright restrictions.