虫体断裂後に自然脱落をみたマダニ眼瞼刺症

A case of tick bite in the eyelid followed by spontaneous extrusion of remnant portion of the worm

　5歳男児が右下眼瞼をダニに刺され，その翌日に受診した。受診直前に他医で虫体の除去がなされたが，脚4本が眼瞼になお残存していた。残存した虫体部分は7日後に自然脱落し，以後の経過も問題なく治癒した。脱落した虫体部分は口下片を含み，ヤマトマダニlxodes ovatus Neumannの雌成虫と同定された。マダニ刺症の続発症の報告は少なく，残存した虫体部分も完全に自然脱落する可能性があり，あえて完全に摘出する必要がない事例もあることを本症例は示している。

A 5-year-old boy presented with a tick bite in the lower eyelid in his right eye inflicted the day before. Removal of the tick had been attempted already. When seen by us, four legs were still clinging to the eyelid. The remnant portion of the tick was spontaneously extruded seven days later and was identified as Ixodes ovatus Neumann. There are few reported cases of tick bite with lasting consequences. This case illustrates that spontaneous extrusion of causative worm may be frequent so that its surgical removal can be deferred depending on circumstances.