Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
Images in Dermatology
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Media and news
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
Images in Dermatology
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Media and news
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF

Translate this page into:

Letter to the Editor - Case Letter
2019:85:5;523-524
doi: 10.4103/ijdvl.IJDVL_136_19
PMID: 31368454

Pigeon tick infestation in humans: A case from North India

Jasleen Kaur Sandhu
 Department of Dermatology, Government Medical College and Hospital, Chandigarh, India

Correspondence Address:
Jasleen Kaur Sandhu
Department of Dermatology, D Block, Level 5, Government Medical College and Hospital, Chandigarh - 160 031
India
How to cite this article:
Sandhu JK. Pigeon tick infestation in humans: A case from North India. Indian J Dermatol Venereol Leprol 2019;85:523-524
Copyright: (C)2019 Indian Journal of Dermatology, Venereology, and Leprology

Sir,

Urban areas with their high-rise buildings provide nesting and breeding facilities for feral pigeons. This, along with availability of food, has led to an explosive increase in population of feral pigeons in the cities. The feral pigeon acts as a host for many ectoparasites like pigeon bug (Cimex columbiaris), red mites (Dermanyssus gallinae), pigeon flea (Ceratophyllus columba), and the most frequent pigeon tick (Argas reflexus).[1] Due to the close proximity of the natural habitat of pigeons and humans in cities, these ectoparasites can cause infestations in humans also. Out of all these, pigeon tick is of the most medical importance because of its potential to transmit tick-borne infections and high rates of sensitization to its bite, with even fatal anaphylactic reactions being reported.[2]

There have been several reports of pigeon tick infestation in humans from Europe.[2],[3],[4] This is a report of pigeon tick infestation in humans from a North Indian city. There are no prior reports of this ectoparasite infestation in humans from India. It is very likely due to underdiagnosis and may not entirely be due to its absence. This report intends to increase the awareness of this infestation among dermatologists and physicians.

A 35-year-old man, a medical professional residing in an urban area, presented to the dermatology outpatient department with a history of recurrent insect bites for the past 3 years. There was history of similar complaints in other family members also. The bites were always noticed in the mornings and occurred only when any of the members slept in a particular bedroom. He also brought along insects which were found in this bedroom. The bites used to occur on exposed parts and caused itchy reddish swellings which were painful. These used to subside in about 10 days to 3 weeks. The bite he presented with had occurred around 2 weeks back. There was no history of generalized rash, hypotension or breathing difficulty. There were no pet animals and he had not noticed any seasonal variation. On examination, a skin-colored papule was seen on the right wrist [Figure - 1]. Microscopic examination of the insect identified it to be a pigeon tick [Figure - 2]. Further enquiries revealed that the patient's family lived on the top floor of a three-storey building and this particular bedroom opened to a balcony which had many pigeons and pigeon nests. The patient was counseled about pigeon tick infestation. He was already contemplating a residence change and did not suffer any new bites after moving to the new residence.

Figure 1: A 2-week-old bite seen as a skin-colored papule (arrow) on the right wrist
Figure 2: Pigeon tick (Argas reflexus) found by the patient in the bedroom

Pigeon tick, Argas reflexus, is one of the most common temporary blood-sucking ectoparasite of feral pigeons. It belongs to the soft tick family Argasidae.[5] It is brownish in color, 4–15 mm long and 6–7 mm wide when unfed. It has a flattened appearance dorsoventrally.[5] The immense ecological success of this tick species is due to its long life span of 7–10 years and the ability to live without blood meal for a long time even upto many years.[1]

Pigeon tick typically lives in and around the nests of feral pigeons and feeds at night while remaining hidden in crevices during the day. It is forced into human dwellings in search of blood meal if the natural host pigeons are not available in sufficient numbers. Although these ticks may attack humans, it is known that it is unable to lay eggs with human blood. Therefore, any human infestation can always be traced back to its natural host pigeon, without which it cannot establish a population.[1]

Bite reactions by the pigeon tick vary from mild mosquito bite–like reaction to severe immunoglobulin E-mediated anaphylaxis.[2],[6] Even fatal anaphylactic shock has been reported.[2] The antigen is likely to be tick salivary proteins and is highly allergenic with induction of hypersensitivity in around 40% of bitten individuals.[4] Anaphylactic shock has been reported in 8% of individuals with pigeon tick bites in a study of 148 cases.[4] The time for resolution of local bite reaction varies from several days to weeks to even years depending on the patients' physiological response to the antigen and presence of any secondary infection.[6]

This ectoparasite infestation very likely suffers from underdiagnosis as there are fewer reports of pigeon tick bites in humans when compared to the high likelihood of its presence in urban areas with large population of pigeons. In this case also, the diagnosis could be made because the patient brought the insects along with him. Otherwise, the cause of skin lesion may have been attributed to some other arthropod and would have been treated symptomatically. The difficulty in diagnosis arises because most of the blood-sucking parasites feed at night, and hide during the day. So the patient is mostly unaware of the source of the bite.

Awareness along with a high index of suspicion is the key to the diagnosis of this potentially life-threatening ectoparasite infestation. Patients need to be asked about the presence of feral pigeons nesting in or around their homes and guided to careful inspection of their living quarters for these parasites for confirmation of the diagnosis.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.

Acknowledgement

The author would like to thank Dr. M. Ramam, Professor, Dermatology and Venereology, AIIMS, New Delhi for the help with the macro photography of the pigeon tick and Dr. Archana Chauhan, Assistant Professor, Department of Zoology, Panjab University, for the identification of the tick.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References
1.
Haag-Wackernagel D, Bircher AJ. Ectoparasites from feral pigeons affecting humans. Dermatology 2010;220:82-92.
[Google Scholar]
2.
Rolla G, Heffler E, Boita M, Doyen V, Mairesse M, Cvackova M, et al. Pigeon tick bite: A neglected cause of idiopathic nocturnal anaphylaxis. Allergy 2018;73:958-61.
[Google Scholar]
3.
Buczek A, Bartosik K, Kulina D, Raszewska-Famielec M, Borzęcki A. Skin lesions in humans bitten by European pigeon tick Argas reflexus (Fab.) (Ixodida: Argasidae) massively occurring in the upper Silesian conurbation of South-West Poland. Ann Agric Environ Med 2018;25:234-40.
[Google Scholar]
4.
Kleine-Tebbe J, Heinatz A, Gräser I, Dautel H, Hansen GN, Kespohl S, et al. Bites of the European pigeon tick (Argas reflexus): Risk of IgE-mediated sensitizations and anaphylactic reactions. J Allergy Clin Immunol 2006;117:190-5.
[Google Scholar]
5.
Walker AR, Bouattour A, Camicas JL, Estrada-Pena A, Horak IG, Latif AA, et al., editors. Biology of ticks and methods of identification. In: Ticks of Domestic Animals in Africa: A Guide to Identification of Species. Edinburgh, Scotland: Biosciences Reports; 2014. p. 21-7.
[Google Scholar]
6.
Bircher AJ. Systemic immediate allergic reactions to arthropod stings and bites. Dermatology 2005;210:119-27.
[Google Scholar]

Fulltext Views
14,544

PDF downloads
1,330
Show Sections