Tick-biting of the Hyalomma spp. as a Vector of Crimean-Congo Hemorrhagic Fever (CCHF): Case Report

Ticks are important ectoparasites that feed on the blood of various livestock hosts and sometimes, humans, which can lead to direct injury or transmission of microorganisms including the agent that causes Crimean-Congo hemorrhagic fever. Case reports of humans being bitten by these ticks can be helpful in preventing disease and improving human health.    A 71-year-old woman from Aran o Bidgol (northern Isfahan Province), referred to her public health center because of a burning sensation, pain and a nodule on the nape of the neck. Clinical examination showed a normal general condition of the patient with no fever reported. Physical examination detected an arthropod attached to the affected area; however there were no other significant findings. The arthropod was carefully removed by a fine-toothed forceps and sent to the medical Entomology Laboratory of the Kashan University of Medical Sciences. Using a stereomicroscope and an identification key, the specimen was identified as female Hyalomma spp. tick, which was completely swollen with the length of 20 mm. After removing of the arthropod, the patient still felt the burning sensation on the bite area. Red bumps and hematoma were also observed, but with no hotness or tenderness. The patient was discharged after prescription of cephalexin 500 mg every 6 hours and gelofen 400 mg p.o. every 8 hours. The red bumps and hematoma subsided after 2 days. The patient was followed for the next 10 days for any symptoms of Crimean-Congo hemorrhagic fever.