Tick bite anaphylaxis has rarely been reported. It may follow the bite of any of the different tick life cycle forms, is related to the release of salivary juices, and may range from mild itch to severe wheeze or shock. Data obtained suggest that it is more common and potentially life threatening than tick paralysis, which is more widely reported. Emergency physicians should recognise this possibility following a tick bite and be prepared to give treatment such as adrenaline rapidly. Patients should be referred to an allergist after recovery.
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