Trop Doct OnlineFirst, published on June 29, 2015 as doi:10.1177/0049475515592494
Case Report
The tick Ixodida: an unusual foreign body in the ear
Tropical Doctor 0(0) 1–2 ! The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0049475515592494 tdo.sagepub.com
Sarmad Alazzawi, Rahmat Omar and Rajagopalan Raman
Abstract We report a patient with a hard tick in her left ear, adherent to the tympanic membrane.
Keywords Ear, tick, Ixodida, foreign body
Figure 1. Endoscopic view of the left external auditory canal (A- tick, B- faecal material).
Introduction
Department of Otorhinolaryngology, Faculty of Medicine, University Of Malaya, Kuala Lumpur, Malaysia
Foreign bodies in the ear are common reasons for emergency room visits, especially in children. The majority of the foreign bodies are seeds, toy accessories, cotton, paper, insects, beads and erasers.1 Patients may
Corresponding author: Sarmad Alazzawi, Department of Otorhinolaryngology, Faculty of Medicine, University Of Malaya, 50603 Kuala Lumpur, Malaysia. Email: [email protected]
Downloaded from tdo.sagepub.com at University of Otago Library on March 28, 2016
2
Tropical Doctor 0(0)
be asymptomatic or present with pain or discharge due to otitis externa. Insects represent about 10% of the foreign bodies in the ear,1 with cockroaches being the most common live insects.2
Case report A 67 year-old woman presented with a 4-day history of itchy, left ear pain associated with a feeling of something moving in it. Otoscopic examination revealed a foreign body in the left ear. Examination under the microscope showed a live, moving tick, surrounded by black faecal material (Figure 1). The right ear was normal. Removal of the tick under the microscope was carried out by application of xylocaine spray (10%) to drown the tick before its removal. The amount of fluid applied was generous enough to cover the entire canal submerging the tick within it. After 5 minutes the tick stopped moving and was then completely removed by suction. The tympanic membrane was erythematous but intact after the procedure and the patient was cured of symptoms.
Discussion
dependent on the blood-meals from host animals. They are broadly classified into three families: Ixodidae (hard ticks); Argasidae (soft ticks); and Nuttalliellidae.3 In this case it was a hard tick. The technique of removal of a tick is very important especially when adherent to the tympanic membrane in order to prevent perforation. Killing the tick is a crucial step prior to removing it. This can be effectively done by drowning the tick, followed by its gentle removal. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
References 1. Singh GB, Sidhu TS, Sharma A, Dhawan R, Jha SK and Singh N. Management of aural foreign body: an evaluative study in 738 consecutive cases. Am J Otolaryngol 2007; 28: 87–90. 2. Kroukamp G and Londt JG. Ear-invading arthropods: a South African survey. S Afr Med J 2006; 96: 290–292. 3. Anisuzzaman, Islam MK, Miyoshi T, Alim MA, Hatta T, Yamaji K, et al. Longistatin, a novel EF-hand protein from the ixodid tick Haemaphysalis longicornis, is required for acquisition of host blood-meals. Int J Parasitol 2010; 40: 721–729.
Ticks are obligate haematophagous ectoparasites and all of their motile life-cycle stages are exclusively
Downloaded from tdo.sagepub.com at University of Otago Library on March 28, 2016
Case Report
The tick Ixodida: an unusual foreign body in the ear
Tropical Doctor 0(0) 1–2 ! The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0049475515592494 tdo.sagepub.com
Sarmad Alazzawi, Rahmat Omar and Rajagopalan Raman
Abstract We report a patient with a hard tick in her left ear, adherent to the tympanic membrane.
Keywords Ear, tick, Ixodida, foreign body
Figure 1. Endoscopic view of the left external auditory canal (A- tick, B- faecal material).
Introduction
Department of Otorhinolaryngology, Faculty of Medicine, University Of Malaya, Kuala Lumpur, Malaysia
Foreign bodies in the ear are common reasons for emergency room visits, especially in children. The majority of the foreign bodies are seeds, toy accessories, cotton, paper, insects, beads and erasers.1 Patients may
Corresponding author: Sarmad Alazzawi, Department of Otorhinolaryngology, Faculty of Medicine, University Of Malaya, 50603 Kuala Lumpur, Malaysia. Email: [email protected]
Downloaded from tdo.sagepub.com at University of Otago Library on March 28, 2016
2
Tropical Doctor 0(0)
be asymptomatic or present with pain or discharge due to otitis externa. Insects represent about 10% of the foreign bodies in the ear,1 with cockroaches being the most common live insects.2
Case report A 67 year-old woman presented with a 4-day history of itchy, left ear pain associated with a feeling of something moving in it. Otoscopic examination revealed a foreign body in the left ear. Examination under the microscope showed a live, moving tick, surrounded by black faecal material (Figure 1). The right ear was normal. Removal of the tick under the microscope was carried out by application of xylocaine spray (10%) to drown the tick before its removal. The amount of fluid applied was generous enough to cover the entire canal submerging the tick within it. After 5 minutes the tick stopped moving and was then completely removed by suction. The tympanic membrane was erythematous but intact after the procedure and the patient was cured of symptoms.
Discussion
dependent on the blood-meals from host animals. They are broadly classified into three families: Ixodidae (hard ticks); Argasidae (soft ticks); and Nuttalliellidae.3 In this case it was a hard tick. The technique of removal of a tick is very important especially when adherent to the tympanic membrane in order to prevent perforation. Killing the tick is a crucial step prior to removing it. This can be effectively done by drowning the tick, followed by its gentle removal. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
References 1. Singh GB, Sidhu TS, Sharma A, Dhawan R, Jha SK and Singh N. Management of aural foreign body: an evaluative study in 738 consecutive cases. Am J Otolaryngol 2007; 28: 87–90. 2. Kroukamp G and Londt JG. Ear-invading arthropods: a South African survey. S Afr Med J 2006; 96: 290–292. 3. Anisuzzaman, Islam MK, Miyoshi T, Alim MA, Hatta T, Yamaji K, et al. Longistatin, a novel EF-hand protein from the ixodid tick Haemaphysalis longicornis, is required for acquisition of host blood-meals. Int J Parasitol 2010; 40: 721–729.
Ticks are obligate haematophagous ectoparasites and all of their motile life-cycle stages are exclusively
Downloaded from tdo.sagepub.com at University of Otago Library on March 28, 2016
