9-year-old boy presented to the outpatient clinic with a tick attached to his tympanic membrane.
A 9-year-old boy presented to the paediatric otolaryngology clinic with complaint of a foreign body sensation in his right ear. The sensation was diagnosed to be because of a tick in the ear, attached to the tympanic membrane. The patient’s history revealed that 3 days earlier he heard a buzzing sound in his ear.
The boy lived in Connecticut and had been playing outdoors at school. He did not have any other complaints of pain, tinnitus or loss of hearing. Physical examination showed that there was a tick attached to the right tympanic membrane associated with surrounding inflammation. The tick was removed with help from an operative microscope at the outpatient clinic. However, the tick could not be removed.
The boy was transferred to an operating room and the tick was removed under general anaesthesia. The tick was attached to the tympanic membrane with its capitulum buried beneath the epidermal layer of the tympanic membrane. The underlying fibrous layer of the membrane was intact. The tick was removed with guidance from an operative microscope with a day hook.
Pathologic testing identified the tick as Dermacentor variabilis. The patient showed no signs or symptoms that suggested a systemic illness after the tick was removed. He was given ciprofloxacin eardrops for an abrasion of the tympanic membrane. The patient reported to be doing well at his one month follow-up with no fever or rashes. The tympanic membrane had also healed well.
References
Tick Attached to the Tympanic Membrane https://www.nejm.org/doi/full/10.1056/NEJMicm1812049
