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Toxin From Tick Bite Paralyses Girl, Stumps Physicians

WebMD Health News

Jan. 12, 2000 (Washington) -- While it is known that certain ticks carry Lyme disease, the common wood tick can cause paralysis and even death if it is not promptly removed. That's the warning from doctors who treated a child in the hospital for two days before a tenacious physician-in-training discovered the eight-legged cause of the child's worsening condition. The child quickly recovered after the tick was removed. Writing in the Jan. 13 issue of TheNew England Journal of Medicine, the physicians describe the devastating effects of the tick bite.

The affected child was a six-year-old girl. In June 1998, she began complaining of a tingling sensation in her fingers, and within six hours was staggering when she walked. The following day she could not walk without help and was taken to the Medical College of Georgia in Augusta. By this time, about 30 hours had passed since her symptoms first appeared.

Once at the hospital, she underwent chest X-rays, MRIs of her head and neck, and other tests that revealed no abnormalities. Still her condition continued to worsen. Her speech was slurred, her arms and legs were becoming paralyzed and she could barely sit up. The physicians thought she had Guillain-Barré syndrome, a collection of symptoms that include sudden paralysis. There is no cure for this syndrome, and those who have it may suffer weakness for years after the initial episode. Treatment for this disorder includes plasmapheresis, in which blood is removed and returned to the patient, minus the plasma component.

At that time Carrie Davis Smith, MD, was in her third year of four-year training to be a pediatrician. She tells WebMD that she was in the child's room as preparations were being made for the plasmapheresis, and suggested that a tick may be the cause of the paralysis. She recalled dogs can harbor wood ticks and remembered that the child's grandmother had said how much she enjoyed playing with the family pooch. Smith was told that someone had already checked the child and found nothing, but she was undaunted.

Using the small black comb that is standard issue with other toiletries given to patients, Smith went section by section through the girl's hair. Stunning her colleagues, Smith discovered an engorged female tick stuck on the left side of the child's scalp.

"I think I yelled, 'Hey, y'all!' when I found it," Smith tells WebMD. "Then I got all excited. We paged Dr. Felz and he came running up and helped us take it off." Michael W. Felz, MD -- who has researched tick-borne diseases for a decade and runs a national tick identification registry -- first photographed the tick, and then kept it in a warmed petri dish in his office.

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