The first reported case of human tick paralysis in Brazil: a new induction pattern by immature stages

Almeida RAMB (1), Ferreira MA (2), Barraviera B (1, 3), Haddad Jr V (4)

(1) Department of Tropical Diseases, Botucatu Medical School, São Paulo State University (UNESP - Univ Estadual Paulista), Botucatu, São Paulo State, Brazil; (2) Undergraduate Program in Medicine, Botucatu Medical School, São Paulo State University (UNESP - Univ Estadual Paulista), Botucatu, São Paulo State, Brazil; (3) Center for the Study of Venoms and Venomous Animals, São Paulo State University (UNESP - Univ Estadual Paulista), Botucatu, São Paulo State, Brazil; (4) Department of Dermatology, Botucatu Medical School, São Paulo State University (UNESP - Univ Estadual Paulista), Botucatu, São Paulo State, Brazil.

Abstract: Tick paralysis (TP) is a rare disease with rapid progression and potential fatal evolution. Immediately after the diagnosis, removal of all ticks from the body of the patient is mandatory. The present study reports for the first time a human case of the disease in Brazil. The patient had loss of muscle strength, decreased reflexes and marked palpebral ptosis. Six hours after removal of the last tick, the ptosis improved and on the following day, the patient had near total regression of the symptoms. This report emphasizes the possible presence of similar cases that should be promptly diagnosed and quickly treated. A new induction pattern for TP in humans associated with immature stages of ticks is also presented.

Key words: tick paralysis, immature ticks, ixodidae.

ACKNOWLEDGMENTS

We would like to thank the special collaboration of Professor Darci Moraes Barros-Battesti, Director of the Laboratory of Parasitology, Butantan Institute, São Paulo, SP, Brazil. Her command of knowledge on ticks was essential to enable us to present a consistent discussion of our case.

COPYRIGHT

© CEVAP 2012

SUBMISSION STATUS

Received: May 14, 2012.

Accepted: August 14, 2012.

Abstract published online: September 3, 2012.

Full paper published online: November 30, 2012.

CONFLICTS OF INTEREST

The authors declare no conflicts of interest.

CONSENT

Informed consent was obtained from the patient for publication of this case report.

CORRESPONDENCE TO

Ricardo Augusto Monteiro de Barros Almeida, Departamento de Doenças Tropicais e Diagnóstico por Imagem, Faculdade de Medicina de Botucatu, UNESP, Distrito de Rubião Jr., s/n, Botucatu, SP, 18618-970, Brasil. Phone: +55 14 3880 1291. Fax: +55 14 3815 9898. Email: almeidaramb@yahoo.com.br.