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Case #399 - July 2015

A skin biopsy specimen was collected from the clavicle region of a 45-year-old male who presented with what appeared to be a pigmented lesion. The patient resides in Kentucky and has no known international travel. The biopsy specimen was sent to Pathology for routine histologic work-up. Objects suggestive of an organism were examined on slides stained with hematoxylin-and-eosin (H&E). The attending pathologist captured images and sent them to CDC-DPDx for diagnostic assistance. Figures A-E represent five of the images received. What is your diagnosis? Based on what criteria?

Case399_A

Figure A

Case399_B

Figure B

Case399_C

Figure C

Case399_D

Figure D

Case399_E

Figure E

Case Answer

The organism depicted in the images was a hard tick (Acari: Ixodidae). Unfortunately, further identification was not possible after specimen processing and subsequent sectioning. In the images, the thick tegument and striated musculature characteristic of arthropods can be observed. In Figure A (arrows) cross-sections of legs can be observed.

Figure A

More on: Ticks

This case and images were kindly provided by the Lexington Clinic, Lexington, KY.

Images presented in the monthly case studies are from specimens submitted for diagnosis or archiving. On rare occasions, clinical histories given may be partly fictitious.

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DPDx is an education resource designed for health professionals and laboratory scientists. For an overview including prevention and control visit www.cdc.gov/parasites/.

  • Page last reviewed: August 24, 2016
  • Page last updated: August 24, 2016
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