Duo Umbilical Dermacentor Variabilis

[Davey Do]

The patient is an active outdoorsy type 64 year old male c/o "itching around my belly button".

Positive for a past history of insect bites in the axillary, ankle, and waistband areas, this patient did not immediately seek treatment until noticing a small umbilical protrusion.  

Initial belief was an umbilical hernia, yet no sensation was felt when the protrusion was clamped with a hemostat. Gentle retraction on hemostat allowed the movement of the protrusion which revealed a 0.5 cm Dermacentor variabilis. Further probing located a smaller 0.25 cm arachnid deeper inside the umbilicus.

The area was cleansed with isopropyl alcohol and TAO applied. Patient tolerated the procedure well, stating, "I think I might enter this in allnurses' "Gross Me Out" Contest!"

[Daisy4RN]

Sounds like someone was rolling around in the hay LOL

[NurseBlaq]

Ewwww *my skin crawling*

[JKL33]

I thought you clamped your belly button skin with a hemostat and pulled on it! ? I thought, "who the heck checks themselves for a hernia this way?!"

I'm with you now.

Yuck. So was it there for awhile or just started its meal recently?

[NurseBlaq]

2 minutes ago, JKL33 said:

I thought you clamped your belly button skin with a hemostat and pulled on it! ? I thought, "who the heck checks themselves for a hernia this way?!"

I'm with you now.

Yuck. So was it there for awhile or just started its meal recently?

?

[sevensonnets]

Chiggers! No more naps in the grass/

[Davey Do]

24 minutes ago, JKL33 said:

Yuck. So was it there for awhile or just started its meal recently?

The patient stated, "I live in the woods, work outside a lot, get bug bites, so I didn't think anything of my belly button itching".

10 hours ago, Davey Do said:

the protrusion which revealed a 0.5 cm Dermacentor variabilis. Further probing located a smaller 0.25 cm arachnid deeper inside the umbilicus.

The smaller of the two arachnids was brownish in color with the larger being more beige in color, possibly indicating that it had consumed a fair amount of the patient's blood.

[caliotter3]

My granddaughter used to complain a lot about always getting bites, which she thought were spider bites, in her bedroom.  I will send her this and see what she thinks.

[Davey Do]

4 minutes ago, sevensonnets said:

Chiggers! 

Trombiculidae are mites, whereas Dermacentor variabilis are arachnids.

The patient stated, "I've had chigger bites on me that I treated with a mixture of hydrocortisone cream and TAO. I've found small ticks on me that I removed and whose bites I've treated with Prid. But I've never had a tick move in my belly button, make itself at home, and use me as its continuous source of nourishment!"

5 minutes ago, caliotter3 said:

  I will send her this and see what she thinks.

The patient did mention that he wanted a second opinion.

[NurseBlaq]

23 minutes ago, Davey Do said:

Trombiculidae are mites, whereas Dermacentor variabilis are arachnids.

The patient stated, "I've had chigger bites on me that I treated with a mixture of hydrocortisone cream and TAO. I've found small ticks on me that I removed and whose bites I've treated with Prid. But I've never had a tick move in my belly button, make itself at home, and use me as its continuous source of nourishment!"

The patient did mention that he wanted a second opinion.

I just know you're not going to deprive us of a toon with a bug eating dinner. ?

[JKL33]

11 hours ago, Davey Do said:

Gentle retraction on hemostat allowed the movement of the protrusion which revealed a 0.5 cm Dermacentor variabilis. Further probing located a smaller 0.25 cm arachnid deeper inside the umbilicus.

Yeah, okay. Man I was really stuck on my "you know you can just poke your finger in there and feel for a defect???" train of thought. ?

Anyway, here's what I think about the 0.5 guy: ?

[Davey Do]

13 hours ago, NurseBlaq said:

I just know you're not going to deprive us of a toon with a bug eating dinner.