Tick anaphylaxis triggered by pulling out the tick

BACKGROUND: Reports of tick anaphylaxis are extremely rare in Asian countries, with poor awareness in these regions. Herein, we report a case of tick anaphylaxis that was triggered by pulling out the tick. CASE PRESENTATION: A 66‐year‐old man developed pruritus in his left toes after returning from a mountain. Three days later, he found a swollen tick biting at the skin between the second and third toes and pulled it out. Approximately 30 min after pulling out the tick, he started to feel a burning sensation in his chest and was brought to our hospital. He was diagnosed with anaphylactic shock (systolic blood pressure, 60 mmHg) and immediately received intramuscular adrenaline. CONCLUSION: To our knowledge, this is the first case of tick anaphylaxis triggered by tick removal in an Asian country. A tick should be removed without pressure on its body, especially in patients with tick or bee allergy.