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Acute otalgia: a case report of mature termite in the middle ear
P Supiyaphun1, P Sukumanpaiboon
1Department of Otolaryngology, Faculty of Medicine Chulalongkorn University, Bangkok, Thailand.
Abstract:
Acute otalgia during childhood is one of the most common complaints in general ENT practice. It may occur as a result of acute otitis externa, otitis media or a foreign body. Animate foreign body in the ear canal or in the middle ear usually results in otalgia and hearing loss. We present a rare case of a living mature termite in the middle ear of a 9-year-old girl complaining of intermittent attacks of otalgia associated with a loud cracking sound in the left ear. In this case, a small perforation of the tympanic membrane without a history of previous trauma, infection, or evidence of a foreign body in the external ear raises a suspicion. A careful, time-consumed microscopic examination could show the living creature in the middle ear. Immediate immobilization and removal of the living foreign body are imperative. In conclusion, tympanic membrane perforation and intermittent severe otalgia without history of otitis may lead to a suspicion of any insects in the middle ear.
Insights
A rare case of a live termite in a child's middle ear caused severe ear pain and cracking sounds. Prompt microscopic examination and removal are crucial for treating animate foreign bodies in the ear.
Area of Science:
- Otolaryngology
- Pediatric ENT
- Medical Entomology
Background:
- Acute otalgia is a common childhood complaint, often caused by otitis externa, otitis media, or foreign bodies.
- Animate foreign bodies in the ear canal or middle ear can lead to otalgia and hearing loss.
Observation:
- A 9-year-old girl presented with intermittent severe otalgia and a loud cracking sound in her left ear.
- Examination revealed a small tympanic membrane perforation without a history of trauma or infection.
- Microscopic examination identified a living mature termite within the middle ear.
Findings:
- The presence of a live insect in the middle ear is a rare etiology of otalgia.
- Tympanic membrane perforation can be an indicator of an animate foreign body in the middle ear.
- The cracking sound was associated with the movement of the termite.
Implications:
- This case highlights the importance of considering animate foreign bodies, such as insects, in the differential diagnosis of pediatric otalgia, especially with tympanic membrane perforation.
- Immediate immobilization and removal of living foreign bodies are imperative to prevent complications.
- Thorough microscopic examination is essential for diagnosing unusual ear canal and middle ear pathologies.