Domestically Acquired Aural Myiasis in a Tennessee Girl.

We present the rare case of a 12-year-old girl from Tennessee with domestically acquired aural myiasis.

Intra-aural tick bite causing unilateral facial nerve palsy in 29 cases over 16 years in Kandy, Sri Lanka: is rickettsial aetiology possible?

BACKGROUND: Over the last two decades intra-aural tick infestation (otoacariasis) has been a common occurrence in the hilly central region in Sri Lanka. Very occasional detection of isolated unilateral facial nerve palsy associated with otoacariasis attributed to toxin damage of the nerve prompted us to study the clinico-epidemiology and aetio-pathology of the problem. METHODS: All cases having isolated unilateral facial nerve palsy associated with otoacariasis presented to, Ear Nose and Throat clinic at General Hospital Kandy, Sri Lanka from 2001 to 2016 were included in the study. The facial palsies were assessed with nerve conduction studies and, harvested ticks were identified. RESULTS: There were 29 patients with mean age of 46 years (range 22-76 years) with male to female ratio of 1:1.9. First 12 patients without specific treatment took 1-55 months for recovery and 4 had axonal degeneration. Last 5 patients were treated with doxycycline and recovered in 4 weeks. They had strong sero-conversion of immunofluorescence antibodies against spotted fever rickettsioses and the tick harvested from the last patient was PCR positive for rickettsial DNA. Identified ticks belonged to Dermacentor, Amblyomma, Rhipicephalus and Hyalomma species. CONCLUSIONS: On contrary to popular toxin theory, we were able to demonstrate treatable rickettsial aetio-pathology as the cause of otoacariasis associated lower motor facial palsy in Sri Lanka.

A Case of Engorged Female Hard Tick in the External Auditory Canal of an Infant.

An oval-shaped mass with a smooth surface was found in the ear canal of a 22-month-old male infant. Although the mass appeared to be almost entirely blocking the ear canal, it was successfully removed under a surgical microscope without general anesthesia at the outpatient department. Under an optical microscope with hematoxylin and eosin staining, the specimen was observed to have a cuticle with a serrated surface and a pore canal, as well as parts of the capitulum, salivary glands, muscles, midgut, and the legs. The specimen was identified as a hard tick of the family Ixodidae, based on gross and histological findings. This paper is the first report in Korea on the diagnosis and treatment of a tick bite in the ear canal.

Demodex Species Infestation in Patients with Ear Itching and Its Relationship to Itch Severity.

OBJECTIVE: The aim of the present study was to investigate Demodex species infestation in patients with ear itching. The relationship between the severity of ear itching and Demodex spp. positivity has not been previously reported in the literature, and we believe that our study will make a significant contribution to the understanding of the etiology of ear itching. METHODS: Fifty patients with itching ears and 54 healthy control patients were asked to use a visual analogue scale (VAS) to rate the itch, the itching period, and the medication used for the itching. All samples were evaluated for Demodex spp. under a light microscope. RESULTS: There was no statistically significant difference between the groups in terms of numbers of Demodex spp. (p=0.154), and there was no statistically significant difference between the groups in terms of Demodex spp. positivity (p=0.054). Despite the lack of statistically significant differences, Demodex spp. infestations were more common in the affected group than in the control group. A positive and strongly significant relationship was observed between the number of Demodex spp. and severity of ear itch in the patient group based on VAS scores (p=0.0001; r=0.724). CONCLUSION: We found that an increased number of Demodex spp. was strongly related to increased severity of ear itching.

Human otoacariasis caused by Amblyomma testudinarium: Diagnosis and management: Case report.

RATIONALE: Tick infestation of the external auditory canal (EAC) constitutes <1% of all patients presenting with ear complaints. Consequently, parameters for the diagnosis and management of ticks in the EAC have not been established. PATIENT CONCERNS: We report 2 cases of EAC infestation by Amblyomma testudinarium in 2 female patients, aged 12- and 72 years old. DIAGNOSES INTERVENTIONS AND OUTCOMES: In both patients, otoscopic examination revealed engorged ticks attached to the ear canal. The 12-year-old girl had a narrow EAC, necessitating slight dislodging of the tick to determine if its mouth parts were embedded in the EAC skin. The tick's mouth parts were confirmed to be free, enabling complete removal of the tick. The 72-year-old woman had a wide EAC, enabling tick removal using Hartman's forceps because the tick's mouth parts were confirmed to be free of the skin. Prophylactic tetracycline (200 mg/day) was administered to each patient for 7 days; neither showed any signs of fever or rash. LESSONS: This report describes 2 patients with A testudinarium infestation of the EAC, and proposes a simple, noninvasive protocol for determining if the tick is anchored to the ear canal.

Aural Myiasis in an Infant.

Myiasis is the parasitic invasion of tissues and organs of human beings by fly larvae. When ear is invaded by the parasitic larvae of flies, this condition is called aural myiasis. Wohlfahrtia magnifica is frequently encountered species in aural myiasis. The authors report a 4-month-old infant from a rural area with aural myiasis caused by W magnifica.

Otoacariasis: demographic and clinical outcomes of patients with ticks in the ear canal / Otoacaríase: desfechos demográficos e clínicos de pacientes com carrapatos no conduto auditivo externo

ABSTRACT INTRODUCTION: Otoacariasis, the attachment of ticks and mites within the ear canal is a common phenomenon especially in rural areas. OBJECTIVE: To determine the clinical and demographic features of cases with detected ticks in the ear canal, which is a common health problem, and identify tick species. METHODS: Data of patients who had otoacariasis were collected. We also investigated all ticks at the Veterinary Department of Kafkas University. RESULTS: We present the data of patients with otoacariasis. All ticks were identified as otobius. Otobius ticks were found not related with any complications. CONCLUSION: It is very important to detect ticks in the ear canal as they act as vector of some diseases. Identifying species of ticks may help clinicians to prevent further complications associated with vector-borne diseases.

Resumo Introdução: A otoacaríase, fixação de carrapatos duros e moles no interior do conduto auditivo, é fenômeno comum, especialmente em áreas rurais. Objetivo: Determinar as características clínicas e demográficas de casos de carrapatos detectados no conduto auditivo externo, um problema de saúde frequente, e identificar as espécies do ácaro. Método: Coletaram-se dados dos pacientes com otoacaríase, e todos os carrapatos foram investigados no Departamento de Veterinária da Universidade Kafkas. Resultados: Os dados de pacientes com otoacaríase são apresentados. Todos os carrapatos foram identificados como pertencentes ao gênero Otobius e constatou-se não haver relação entre os carrapatos e qualquer tipo de complicação. Conclusão: É muito importante detectar carrapatos no conduto auditivo externo, pois esses ácaros funcionam como vetores para algumas doenças. A identificação da espécie do ácaro pode ajudar o clínico a prevenir complicações associadas às doenças transmitidas por esse vetor.

Otoacariasis: demographic and clinical outcomes of patients with ticks in the ear canal.

INTRODUCTION: Otoacariasis, the attachment of ticks and mites within the ear canal is a common phenomenon especially in rural areas. OBJECTIVE: To determine the clinical and demographic features of cases with detected ticks in the ear canal, which is a common health problem, and identify tick species. METHODS: Data of patients who had otoacariasis were collected. We also investigated all ticks at the Veterinary Department of Kafkas University. RESULTS: We present the data of patients with otoacariasis. All ticks were identified as otobius. Otobius ticks were found not related with any complications. CONCLUSION: It is very important to detect ticks in the ear canal as they act as vector of some diseases. Identifying species of ticks may help clinicians to prevent further complications associated with vector-borne diseases.

Tick-Induced Facial Palsy.

Ticks are obligate blood-sucking arthropods that exist worldwide. Their targets include all vertebrates and humans. Ticks are harmful to people with regard to transmission in many viral, bacterial, and parasitic infections. In addition to these diseases and toxin-induced neurological complications, tick-induced paralysis is a syndrome related to neurotoxin production, and its mortality ratio in the literature is reported to be approximately 10%. Tick-induced isolated facial paralysis is a rare form of the disease developing because of attachment to the external auditory canal or attachment behind the ear. Our country and region are under risk in terms of included tick habitat for tick-induced paralysis that is responsible particularly for hard ticks. In our article, we aimed to present a case with isolated facial paralysis that occurred after the internal auditory canal was bitten by Hyalomma margintum species belonging to the hard ticks group and to probe the management of this disease.

A new species of the genus Demodex Owen, 1843 (Acari: Demodecidae) from the ear canals of the house mouse Mus musculus L. (Rodentia: Muridae).

A new species Demodex conicus n. sp. is described based on adult and juvenile stages from the ear canals of the house mouse Mus musculus L. in Poland. The new species is most similar to D. auricularis Izdebska, Rolbiecki & Fryderyk, 2014 from the ear canals of the wood mouse Apodemus sylvaticus (L.), but differs in the following features: the gnathosoma is triangular, the supracoxal spines (setae elc.p) are conical, the spines on the terminal segment of palp are four, the striation on opisthosoma is fine but dense, the vulva is located at a distance of c.17 µm from posterior level of legs IV, and the male genital opening is located at the level of legs I. The differences also relate to body size and proportions, female D. conicus n. sp. being, on average slightly larger, and male significantly larger than D. auricularis. Males of the new species also have longer and more massive opisthosoma than males of D. auricularis. Demodex conicus n. sp. was found in 17.5% of the mice studied from different locations in Poland.

The first case of otomyiasis caused by Sarcophaga spp. (Diptera; Sarcophagidae) larvae in a goose in the world.

Otomyiasis was diagnosed in the right ear of a 3-month-old goose. Twenty-three of 25 larvae were in the meatus acusticus externus, and 2 larvae were under the skin. The larvae were in the third larval stage of Sarcophaga spp. by microscopic examination. A case of otomyiasis was reported in goose for the first time in the world on the basis of morphological characteristics (macroscopic and microscopic evaluation) in this communication.

Preventive efficacy of a topical combination of fipronil--(S)-methoprene--eprinomectin--praziquantel against ear mite (Otodectes cynotis) infestation of cats through a natural infestation model.

A study based on naturally infested cats was designed to evaluate the effectiveness of a single treatment with a topical formulation containing fipronil, (S)-methoprene, eprinomectin and praziquantel, for the prevention of Otodectes cynotis infestation in cats. Six treated cats and six untreated cats were housed with three chronically Otodectes cynotis-infested cats, respectively. The cats of each group were kept together in a 20-m(2) room for 1 month. Both clinical examination and ear mite counts were conducted on Day 28. All donor cats were confirmed to be chronically infested with Otodectes cynotis on Day -1 and Day 28. From untreated control cats, 129 live mites were recovered on Day 28 and all cats were found to be infested. In the treated group, three cats were found to be infested, with a total of five live mites recovered, the difference between the two groups being significant (p = 0.003). One treatment corresponded to 96% preventive efficacy at Day 28 based on ear mite counts. With regard to cerumen, the clinical score increased significantly for untreated cats between Day -1 and Day 28 (p = 0.00026) and not for treated cats (p = 0.30). The difference in cerumen abundance was significant between untreated and treated cats on Day 28 (p = 0.0035). Concerning the pruritic reflex in at least one ear, all cats were negative at inclusion. All six untreated cats became positive and showed a reflex on Day 28, whereas no treated cat showed ear pruritus (p = 0.00026).

Investigation of demodex species frequency in patients with a persistent itchy ear canal treated with a local steroid.

OBJECTIVE: To investigate the frequency of demodex species in the external acoustic meatus in patients with an itchy ear canal. METHODS: Patients were assigned to one of three groups. Group one consisted of 54 patients with an itchy ear canal who were using a local agent, while group two was composed of 51 patients with an itchy ear canal who were not using a local agent. Group three consisted of 50 healthy individuals without an itchy ear canal. RESULTS: Demodex species test results were positive in nine (5.8 per cent) of the cases. Six of these positive cases were in group one, two in group two and one in group three. The frequency of demodex species in the external acoustic meatus was similar between those patients with an itchy ear canal who did not use a local agent and the healthy individuals (p = 0.571), but it was significantly higher in those using a local steroid compared with those not using a local agent (p = 0.046). CONCLUSION: Although demodex species was not significantly higher in patients with an itchy ear canal compared with the control group, use of a local steroid increased the parasite frequency in the external ear canal of affected patients.

Impacted cerumen or something else?

Despite having a tick in his ear canal for more than a month, the patient was doing well.

Outer ear canal infection with Rhabditis sp. nematodes in a human.

Here we report the first human case of an outer ear canal infection with a free-living nematode of the genus Rhabditis. Otomicroscopy revealed viable worms in the outer ear canal of a patient suffering from chronic otorrhea and hearing loss. The nematode was identified by microscopy and internal transcribed spacer (ITS)-PCR.