The lone star tick (Amblyomma americanum) in the United States spreads diseases such as Ehrlichiosis, Rocky Mountain spotted fever, tularemia, and STARI. Their aggressive biting and covert attachment require immediate removal and avoidance of infested areas. We present a case report of a 28-year-old male entomologist who presented to the emergency department after being bitten by numerous lone star ticks while collecting samples. He experienced skin reactions at the bite sites and was started on doxycycline for prophylaxis. Antihistamines were prescribed, and he was advised to carry an epinephrine auto-injector and avoid allergens. Blood tests showed no abnormalities. Additionally, he developed an alpha-gal allergy from the tick bites, leading to allergies to various foods and environmental factors. This is likely due to the introduction of alpha-gal into the body through the tick bites, leading to an immune response and subsequent allergic reactions. The patient's condition also involves allergies to environmental antigens such as Timothy grass, white oats, and American elm. A personalized dietary plan, avoidance of allergens, and preventive measures against tick bites were recommended. Osteopathic considerations, immunological testing, and referral to an allergist were suggested for further management. He planned to undergo tests for alpha-gal and alpha tryptase but encountered difficulties due to insurance issues. This case highlights the challenges faced by patients in accessing necessary diagnostic tests for tick-related allergies and emphasizes the importance of addressing insurance barriers to ensure appropriate care for individuals at risk. In conclusion, this case highlights the challenges faced by patients in accessing diagnostic tests for tick-related allergies due to insurance issues, underscoring the need to address these barriers to ensure appropriate care for individuals at risk of developing multiple allergies following lone star tick bites.

The Last Bite: Development of Nonspecific Allergic Response After Environmental Trigger

 Allergy and Immunology / Infectious Disease

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