Simon, 32, presents with a 24-hour history of an itchy red weal on the torso.

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<p>Simon, 32, presents with a 24-hour history of an itchy red weal on the torso (pictured). He is otherwise well, with no systemic symptoms.</p><p>He went bushwalking on the weekend in a national park in a tick-endemic region on the east coast. Simon has previously sustained a number of tick bites and has usually removed the tick himself with fine tweezers.</p><p>The last time, however, he experienced an extensive local reaction around the bite site after removing the tick, developing a 30cm weal, which took nearly a week to resolve. For this reason, he has not attempted removal this time.</p>

Dr Kate Kelso is a GP and medical editor at Australian Doctor.