Prolonged Attachment of Rhipicephalus microplus Tick Without Systemic Manifestations: A Case Report.

Rhipicephalus microplus, commonly known as the Asian blue tick, is a cattle parasite rarely reported to infest humans. We describe a 70-year-old Saudi man who presented with a month-long, asymptomatic tick attachment on his left flank after a camping trip. Examination revealed a live, engorged tick with mild surrounding erythema and edema but no systemic symptoms. Laboratory investigations were unremarkable, and histopathology of a punch biopsy showed eosinophilic dermatitis consistent with a localized hypersensitivity reaction. The tick was removed intact and identified as R. microplus by the regional public health laboratory. Although this species is not recognized as a human pathogen, a 14-day course of doxycycline was prescribed as a precaution. At two-week follow-up, the lesion had completely healed, and the patient remained free of systemic illness. This case illustrates that even non-pathogenic tick species can remain attached to human hosts for prolonged periods and provoke localized inflammatory responses, underscoring the importance of careful tick removal, species identification, and individualized management of prolonged tick bites.