Ectoparasites from feral pigeons affecting humans

Feral pigeons pose a considerable health risk to the human population. They are vectors of infectious diseases and source of antigens causing allergic diseases. Breeding and roosting sites of pigeons harbor parasites that may infest humans. In the present article, a concomitant parasitization of a young female with 3 different ectoparasites, the bedbug Cimex lectularius, the pigeon tick Argas reflexus and the red mite Dermanyssus gallinae, is reported. The parasites invaded the apartment from a balcony used as roost by feral pigeons and infested the patient continuously over a period of more than 2 months. To our knowledge this case presents the first record of a coincidental infestation of a single patient with several ectoparasite species deriving from feral pigeons. Additionally we report general symptoms in the patient probably caused by the high number of stings. Dermatologists should be aware of the possibility of an infestation with ectoparasites deriving from feral pigeons. In a review we give an overview on the most important ectoparasites transmitted from feral pigeons to humans and their importance for the dermatologist.